T3/T4值、TRAb和ALP在育龄期女性甲状腺毒症中的鉴别价值

Differential diagnosis value of T3/T4 ratio,TRAb and ALP in female patients of child-bearing period with thyrotoxicosis

目的:探讨T3/T4值、TRAb和ALP在鉴别育龄期女性Grave’s病和破坏性甲状腺炎中的价值。方法:比较82例Graves’病和32例甲状腺炎患者的T3/T4值、TRAb和ALP水平,应用ROC评价其对Graves’病和甲状腺炎的鉴别价值。结果:Graves’病组T3/T4值、TRAb和ALP较甲状腺炎组均显著升高(P<0.01),3个指标鉴别诊断的灵敏度和特异度良好,其中TRAb的灵敏度和特异度分别达0.878和0.969,3个指标的最佳诊断界点分别为20.29(nmol/μmol)、2.805IU/L和143.5IU/L。结论:T3/T4值、TRAb和ALP简便、安全,可用于育龄期女性甲状腺毒症患者的鉴别诊断,TRAb应作为其首选指标。

Objective：To investigate the values of T3/T4 ratio,TRAb and alkaline phosphatase （ALP） in the differential diagnosis of Graves＇disease（GD） and thyrotoxicosis in female patients of child-bearing period. Methods：T3/T4 ratio,TRAb and ALP of 82 patients with GD and 32 patients with thyrotoxicosis were compared, and their values in the differential diagnosis were evaluated by receiver operator characteristic curve. Results： T3/T4 ratio, TRAb and ALP were higher in GD group than those in thyrotoxicosis group（P〈0.01）.The three index showed good sensitivity and specificity. Their optimization cut-off values were 20.29（nmol/μmol）,2.805 IU/L and 143.5 IU/L respectively while the sensitivity and specificity of TRAb were 0.878 and 0.969 respectively. Conclusion：Because of its convenience and safety, T3/T4 ratio, TRAb and ALP could be used in the differential diagnosis of thyrotoxicosis in female patients of child-bearing period, and TRAb would be prefered.