HA和IGF-1检测对甲状腺相关性眼病活动度的评价

Evaluationon Activity of Thyroid-associate Ophthalmopathy with Serum Hyaluronic Acid and Insulin-like Growth Factor-1

目的 分析甲状腺相关眼病（TAO）患者血清透明质酸（HA）和胰岛素样生长因子（IGF-1）水平,为甲状腺相关眼病活动度评价提供实验室指标.方法 TAO患者55例且甲状腺功能控制在正常范围,根据临床活动度评分（CAS）分为活动期组（CAS≥4分,共30例）和静止期组（CAS＜4分,共25例）,根据NOSPECS对TAO患者分级,本组病例均为2～4级;无TAO正常对照组35例.采用放射免疫法测定血清HA和IGF-1浓度.应用受试者工作特性曲线（ROC曲线）评价HA、IGF-1对TAO患者活动度的诊断价值.结果 ①TAO活动期组患者血清HA、IGF-1水平明显高于静止期组及正常对照组（P＜0.01）;活动期HA、IGF-1分别是静止期组患者的2.38倍、2.82倍,是正常对照组的2.80倍、3.09倍.②HA、IGF-1的水平变化随TAO的分级程度增加而升高,差异均有统计学意义（P＜0.05）.③TAO患者的HA、IGF-1在ROC曲线下面积分别为0.933,0.927.HA、IGF-1诊断TAO活动度的平均灵敏度、特异度分别是93.8％、86.1％、91.6％、84.1％.结论 血清HA和IGF-1水平与TAO活动度有关,参与TAO的发生.HA和IGF-1能够作为TAO活动度的实验室评价指标.

Objective To detect the level of serum hyaluronic acid （HA） and insulin-like growth factor -1 （IGF-1 ） in thyroid-associate ophthalmopathy （TAO） patients and to provide experimental evaluation of the activity of TAO. Methods 55 cases of OTA patients with normal thyroid functions were involved. The patients based on Clinical Activity Score （CAS） were classified to activity stage group （CAS≥4,30 cases） and resting stage group （CAS 〈4,25 eases）. 36 people without TAO and thyroid-associated disease were enrolled into the control group. The levels of serum HA and IGF-1 in patients and healthy controls were measured by radioimmunoassay. The receiver operator characteristic curve was used to evaluate the diagnostic value for the activity of thyroid- associate ophthalmopathy. Results The serum HA and IGF- 1 levels in active stage group were significantly higher than that of resting stage group and control group （P 〈 0.01 ）. The levels HA and IGF- 1 in active stage group were 2.38 and 2.82 times higher than that of in resting stage group, and 2.80 and 3.09 times higher than that of in the control group respectively. The serum HA and IGF-1 levels were increased with the increase of severity of TAO （P 〈 0.05 ）. The receiver operator characteristic curve （ ROC ） showed that the area under curve of HA and IGF- 1 from TAO patients were 0.933 and 0.927 respectively. The average sensitivity and specificity of HA and IGF-1 for diagnosis the activity of TAO were 93.8% ,86. 1% ,91.6 % and 84. 1% respectively. Conclusion The serum levels of HA and IGF- 1 are correlated with the activity of thyroid associatedophthalmopathy. The serum ophthalmopathy. The serum activity of TAO. HA and IGF-1 might be HA and IGF-1 could be used involved in the development of thyroid-associated as index for providing experimental evaluation of the