难治性甲状腺功能亢进症患者血流动力学参数与血清学指标的相关性

Correlation between hemodynamic parameters and serological indicators in patients with refractory hyperthyroidism

目的分析难治性甲状腺功能亢进症(以下简称甲亢)患者的血流动力学变化,探讨其与血清学指标的相关性。方法选取156例难治性甲亢患者(甲亢组)及与之年龄、性别相匹配的健康志愿者121例(正常对照组),两组均行超声检查和实验室检查,比较其血流动力学变化、血清学指标总三碘甲腺原氨酸(TT3)、总甲状腺素(TT4)、游离三碘腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)水平;应用Pearson相关分析法分析血流动力学参数与血清学指标间的相关性。结果甲亢组患者甲状腺体积、最高流速、管径均高于正常对照组(均P<0.05),血流阻力指数大于正常对照组,差异无统计学意义;甲亢组患者血清TT3、TT4、FT3、FT4水平均高于正常对照组(均P<0.05),TSH水平低于正常对照组(P<0.05)。Pearson相关分析显示TSH水平与甲状腺体积、最高流速、管径均呈负相关(均P<0.05);TT3、TT4、FT3、FT4水平与甲状腺体积、最高流速、管径均呈正相关(均P<0.05)。结论难治性甲亢患者的甲状腺体积、最高流速、管径均与血清学指标相关,可为临床诊治和监测提供参考依据。

Objective To investigate the hemodynamic changes of patients with refractory hyperthyroidism and its correlation with related serological indicators.Methods One hundred and fifty-six patients with refractory hyperthyroidism(hyperthyroidism group)and 121 healthy individuals as the control group were enrolled.All the selected subjects were underwent ultrasonography and laboratory examination.Various indexes were compared between two groups,including hemodynamic parameters,serological indicators total triiodothyronine(TT3),total thyroxine(TT4),free triiodothyronine(FT3),free thyroxine(FT4),and thyroid stimulating hormone(TSH).The correlation between hemodynamic parameters and serological parameters was analyzed by Pearson correlation analysis.Results The thyroid volume,maximum blood flow velocity and tube diameter of the hyperthyroidism group were significantly higher than those of the control group(all P<0.05).The blood flow resistance index of the hyperthyroidism group was higher than that of the control group,with no significant difference.The levels of serum TT3,TT4,FT3 and FT4 of the hyperthyroidism group were significantly higher than those of the control group(all P<0.05),and TSH level was lower than that of the control group(P<0.05).Pearson correlation analysis showed that TSH level were negatively correlated with thyroid volume,maximum blood flow velocity,and tube diameter(all P<0.05),while TT3,TT4,FT3 and FT4 were positively correlated with thyroid volume,maximum blood flow velocity and tube diameter(all P<0.05).Conclusion The thyroid volume,maximum blood flow velocity and tube diameter of patients with refractory hyperthyroidism are correlated with serological indicators,which can reflect the severity of refractory hyperthyroidism,thus providing reliable reference for diagnosis,treatment and monitoring of refractory hyperthyroidism.