红细胞沉降速率联合C反应蛋白在亚急性甲状腺炎诊断中的应用价值

Role of erythrocyte sedimentation rate combined C reactive protein in the diagnosis of subacutethyroiditis

目的探讨红细胞沉降速率(ESR)联合C反应蛋白(CRP)在亚急性甲状腺炎(SAT)诊断中的应用价值。方法选取2011年1月—2015年12月期间北京安贞医院内分泌代谢科收治的214例SAT患者为观察组,同期288例毒性弥漫性甲状腺肿(Graves病)患者为对照组。检测2组患者甲状腺相关指标[血清游离T3(FT3)、游离T4(FT4)、促甲状腺激素(TSH)、促甲状腺受体抗体(TRAb)、甲状腺过氧化物酶抗体(TPOAb)、摄碘率]、CRP和ESR水平,并进行统计学比较。绘制CRP、ESR、二者联合检查诊断SAT的ROC曲线,并比较敏感度、特异度及曲线下面积(AUC)。结果观察组FT3、FT4水平显著高于对照组,差异有统计学意义(P<0.05);观察组TSH、TPOAb、摄碘率水平显著低于对照组,差异有统计学意义(P<0.05)。观察组CRP、ESR水平显著高于对照组,差异有统计学意义(P<0.05)。ESR联合CRP诊断SAT的敏感度为96.7%,高于ESR的86.5%和CRP的92.5%,但差异无统计学意义(P>0.05)。ESR联合CRP诊断SAT的AUC为0.804,高于ESR的0.698和CRP的0.755。结论红细胞沉降速率联合C反应蛋白可有效诊断亚急性甲状腺炎,效果优于红细胞沉降速率、C反应蛋白的单独应用。

Objective To study the value of erythrocyte sedimentation rate（ ESR） combined C reactive protein（ CRP） in the diagnosis of subacutethyroiditis（ SAT）. Methods Two hundred and fourteen cases of SAT from January,2011 to December,2015,and 288 cases of Graves disease in the same period were selected. The thyroid related indicators（ FT3,FT4,TSH,TRAb,TPOAb and Iodine uptake rate）,CRP and ESR levels were detected and statistical compared. The ROC curve of CRP,ESR and CRP combined ESR on diagnosis of subacute thyroiditis were made,and the sensitivity,specificity,and area under curve（ AUC） were compared. Results The FT3 and FT4 levels of the observation group were significantly higher than those of the control group,the difference was statistically significant（ P〈0. 05）. The TSH,TPOAb and Iodine uptake rate of the observation group were significantly lower than those of the control group,the difference was statistically significant（ P〈0. 05）. The CRP and ESR levels of the observation group were significantly higher than those of the control group,the difference was statistically significant（ P〈0. 05）. The sensitivity of CRP combined ESR on the diagnosis of SAT was 96. 7%,which was higher than that of CRP（ 92. 5%） and ESR（ 86. 5%）,but the difference was not statistically significant（ P〉0. 05）. The AUC of CRP combined ESR on the diagnosis of SAT was 0. 804,which was higher than that of CRP（ 0. 755） and ESR（ 0. 804）. Conclusion Erythrocyte sedimentation rate combined C reactive protein could be used as the effective diagnosis indicators of subacutethyroiditis,and the effect was better than only erythrocyte sedimentation rate or C reactive protein.