甲状腺过氧化物酶抗体滴度与B超对产后甲状腺炎的诊断价值

The diagnosis value of B ultrasound and postpartum thyroiditis in patients with thyroid peroxidase antibody titer

目的探究与分析甲状腺过氧化物酶抗体(TPO-Ab)滴度与B超对产后甲状腺炎(PPT)患者的诊断价值。方法选取自2013年5月起至2015年4月接受治疗的产后甲状腺炎患者96例作为调查研究对象,收集其确诊时TPO-Ab滴度、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)及甲状腺B超检查结果,并进行18个月的产后随访。分析研究患者TPO-Ab、甲状腺功能变化及超声检查情况。结果 1产后甲状腺炎患者临床表现多样,既可以表现为甲减,也可以表现为甲亢。2TPO-Ab滴度检测结果:96例患者确诊检查时,72例(75.00%)为TPO-Ab阳性,74例出现甲亢症状,22例出现甲减症状;96例患者经治疗后,进行为期18个月的随访,由随访结果可知仍有17例(17.71%)患者TSH<0.30 m U/L。3甲状腺B超检测结果:96例患者均表现为双侧甲状腺弥漫性增大,回声类型共分为三种,其中A型(回声正常)10例,B型(回声分布不均匀)22例,C型(回声弥漫性降低)64例。96例患者进行为期18个月的随访,由随访结果可知,10例回声正常者,其TSH值也恢复至正常范围;22例回声不均匀者,2例TSH>4.8 m U/L;64例回声弥漫性降低者,7例TSH>4.8 m U/L。4两种诊疗方法结果对比:C型组TPO-Ab滴度、TSH值均明显高于A型组与B型组,差异对比,统计学上有意义(P<0.05)。结论甲状腺B超检测无明显特异性,结合TPO-Ab滴度后诊断价值更高,结果更为准确,同时,超声图像中的回声范围与TPO-Ab滴度及甲状腺功能损害情况密切相关。

Objective To explore and analyze the value of the thyroid peroxidase antibody（ TPO Ab） titer and B ultrasound in the diagnosis of postpartum thyroiditis（ PPT）. Methods From May 2013 to April 2015 in our hospital,96 cases of postpartum thyroiditis patients were selected as the research objects. TPO Ab titer,FT3,FT4,TSH and thyroid ultrasound examination results at the moment of making the diagnosis were collected,and postpartum follow- up of 18 months were performed. To analyze the TPO- Ab,thyroid function changes and the results of ultrasonic examinations. Results ①The clinical manifestations of the patients with postpartum thyroiditis was diverse,which can be showed as hypothyroidism,as well as hyperthyroidism. ②thyroid peroxidase antibody titer detection results： 96 patients were diagnosed,72 cases（ 75%） with positive TPO AB,74 cases with hyperthyroidism,22 patients with hypothyroidism; after a period of 18 months follow- up of the 96 patients,the results showed that there were still 17 patients（ 17. 71%） with TSH 〈0. 30 mU / L. ③thyroid ultrasound examination results： 96 patients showed bilateral thyroid diffuse enlargement,and echo pattern was divided into three,type A（ normal echo） in 10 cases,type B（ echo was unevenly distributed） in 22 cases,type C（ echo diffuse decrease） in 64 cases. After a period of 18 months follow- up of the 96 patients,the results showed10 cases of normal echo and the TSH values also restored to normal range; 22 cases with uneven echo,2 cases with thyroid stimulating hormone（ TSH）〉 4. 8 mu/L; 64 patients with diffuse decreased echo,7 cases with thyroid stimulating hormone（ TSH） 〉4. 8 mU/L. ④comparison of the two methods： AB titers and TSH values in C group were significantly higher than those in A group and B group,the difference is statistically significance（ P〈0. 05）. Conclusion Thyroid ultrasound examination has no obvious specificity. If it bind with thyroid peroxidase antibody titers,the diagnostic value is higher and the result is more accurate. At the same time,the ultrasonic image of echo range,thyroid peroxidase antibody titers and thyroid dysfunction is closely related.