血清IL-4、T_(3)/T_(4)、FT_(3)/FT_(4)在Graves病患者不同时期的表达水平分析及其对Graves病早期诊断意义探讨

Analysis of the expression levels of serum IL-4, T_(3)/T_(4) and FT_(3)/FT_(4) in patients with Graves disease at different periods and their significance in the early diagnosis of Graves disease

目的分析血清白细胞介素-4(IL-4)、三碘甲状腺原氨酸/甲状腺激素(T_(3)/T_(4))、游离三碘甲状腺原氨酸/游离甲状腺激素(FT_(3)/FT_(4))在Graves病患者不同时期的表达水平,探讨血清IL-4、T_(3)/T_(4)、FT_(3)/FT_(4)对Graves病的早期诊断意义。方法回顾性选取2017年8月至2019年12月唐山市工人医院收治的30例初发Graves病患者作为观察组,另选取30例同期健康体检者作为对照组。检测观察组治疗前、治疗后1、3个月和对照组的血清IL-4、T_(3)、T_(4)、FT_(3)、FT_(4),计算T_(3)/T_(4)、FT_(3)/FT_(4),然后进行统计分析。采用受试者工作特征(ROC)曲线分析血清IL-4、T_(3)/T_(4)、FT_(3)/FT_(4)早期诊断价值。结果观察组治疗前、治疗后1、3个月血清IL-4、TT_(3)、TT_(4)、FT_(3)、FT_(4)明显高于对照组,且观察组患者治疗前、治疗后1个月IL-4、TT_(3)、TT_(4)、FT_(3)、FT_(4)明显高于治疗后3个月,差异均有统计学意义(P<0.05);观察组治疗前、治疗后1个月T_(3)/T_(4)、FT_(3)/FT_(4)明显高于对照组,且观察组患者治疗前、治疗后1个月T_(3)/T_(4)、FT_(3)/FT_(4)明显高于治疗后3个月,差异均有统计学意义(P<0.05);ROC曲线分析显示,IL-4、T_(3)/T_(4)、FT_(3)/FT_(4)的曲线下面积(AUC)分别为0.891、0.846和0.898,说明血清IL-4、T_(3)/T_(4)、FT_(3)/FT_(4)对Graves病的早期诊断有明显价值。结论Graves病患者不同时期血清IL-4、T_(3)/T_(4)、FT_(3)/FT_(4)水平均较正常人异常升高,随着治疗时间的延长,有降低趋势,并血清IL-4、T_(3)/T_(4)、FT_(3)/FT_(4)水平对Graves病的早期诊断有明显价值。

Objective To analyze the expression levels of serum interleukin-4(IL-4),triiodothyronine/thyroid hormone(T_(3)/T_(4)),free triiodothyronine/free thyroid hormone(FT_(3)/FT_(4))in patients with Graves'disease at different stages,and to explore the significance of serum IL-4,T_(3)/T_(4),FT_(3)/FT_(4) in the early diagnosis of Graves'disease.Methods Thirty patients with Graves'disease who were treated in Tangshan Workers'Hospital from August 2017 to March 2019 were selected as the research object and the observation group was selected.Another 30 healthy subjects who were examined during the same period were selected as the control group.Serum IL-4,T_(3),T_(4),FT_(3),FT_(4),calculate T_(3)/T_(4),FT_(3)/FT_(4),and then perform statistical analysis.The early diagnosis value of serum IL-4,T_(3)/T_(4),FT_(3)/FT_(4) was analyzed by receiver operating characteristic(ROC)curve analysis.Results The levels of serum IL-4,T_(3),T_(4),FT_(3),and FT_(4) in the observation group were significantly higher than those in the control group before treatment,1 month,and 3 months after treatment,and the levels of IL-4,T_(3),and T_(4),FT_(3),and FT_(4) in the observation group before treatment,1 month after treatment were significantly higher than 3 months after treatment,the differences were statistically significant(P<0.05).The levels of T_(3)/T_(4) and FT_(3)/FT_(4) in the observation group before treatment,1 month after treatment were significantly higher than those in the control group,and the levels of T_(3)/T_(4) and FT_(3)/FT_(4) in the observation group before treatment,1 month after treatment were significantly higher than after 3 months,the differences were statistically significant(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)of IL-4,T_(3)/T_(4),FT_(3)/FT_(4) were 0.891,0.846,and 0.898,indicating that serum IL-4,T_(3)/T_(4),and FT_(3)/FT_(4) pairs Early diagnosis of Graves disease has clear value.Conclusion The levels of serum IL-4,T_(3)/T_(4),and FT_(3)/FT_(4) in patients with Graves'disease at different periods are abnormally higher than those in normal people.With the extension of treatment time,there is a tendency to decrease.And the levels of serum IL-4,T_(3)/T_(4),FT_(3)/FT_(4) has obvious value for the early diagnosis of Graves disease.