彩色多普勒超声联合甲状腺激素诊断妊娠甲亢合并Graves病效能

The efficacy of color Doppler ultrasound combined with thyroid hormone level for diagnosing hyperthyroidism with Graves disease of pregnant women

目的:探究彩色多普勒超声与甲状腺激素对妊娠甲亢合并Graves病(GD)的诊断价值。方法:选取2017年11月-2019年12月本院收治的妊娠甲亢患者120例,其中合并GD 102例,未合并GD 18例,同期本院产前检查健康孕妇120例为对照组,对比分析3组彩色多普勒超声指标(STA-PSV、STA-D)和甲状腺激素相关指标(FT4、FT3、TRAb、TPOAb、TGAb)水平,采用受试者工作特征(ROC)曲线分析各指标诊断妊娠甲亢合并GD价值。结果:合并GD组STA-PSV、STA-D、FT4、FT3、TRAb、TPOAb、TGAb高于未合并GD组和对照组,TSH低于未合并GD组和对照组(均P<0.05);未合并GD组FT4、FT3、TPOAb高于对照组,TSH低于对照组(均P<0.05)。ROC曲线分析显示,STA-PSV、STA-D、TSH、FT4、FT3、TRAb、TPOAb、TGAb诊断妊娠甲亢合并GD的AUC分别为0.808、0.814、0.840、0.828、0.850、0.854、0.851、0.763、0.953,在最佳临界值时联合检测的敏感度和特异度(100.0%、81.9%)最高。结论:彩色多普勒超声和甲状腺激素指标联合诊断妊娠甲亢合并GD价值较高。

Objective:To explore the efficacy of color Doppler ultrasound combined with thyroid hormone level for diagnosing hyperthyroidism and Graves disease(GD)of pregnant women.Methods:120 pregnant women with hyperthyroidism were included in group A from November 2017 to December 2019,which included 102 women with GD in group A1 and 18 women without GD in group A2.120 healthy pregnant women were selected in control group during the same period.The indexes of color Doppler ultrasound examination,such as STA-PSV and STA-D,and thyroid hormone levels,such as FT4,FT3,TRAb,TPOAb,and TGAb of the women were compared among the three groups.Receiver operating characteristic(ROC)curve were used to analyze the value of indexes of color Doppler ultrasound examination and thyroid hormone levels for diagnosing hyperthyroidism and GD of the pregnant women with.Results:The values of STA-PSV and STA-D,and the levels of FT4,FT3,TRAB,TPOAb and TGAB of the women in group A1 were significant higher than those of the women in group A2 and in control group,but the TSH level was of the women in group A1 was significant lower(P<0.05).The levels of FT4,FT3 and TPOAb of the women in group A2 were significant higher than those of the women in control group,but the TSH level of the women in group A2 was significant lower(P<0.05).ROC curve analysis shows that the AUC of the STA-PSV value,the STA-D value,the TSH level,the FT4 level,the FT3 level,the TRAB level,the TPOAb level,and the TGAB level for diagnosing hyperthyroidism and GD of the pregnant women with were 0.808,0.814,0.840,0.828,0.850,0.854,0.851,0.763,and 0.953,respectively.The sensitivity and the specificity(100.0% and 81.9%)of color Doppler ultrasound combined with thyroid hormone levels for diagnosing hyperthyroidism and GD of the pregnant women were the highest at the optimal cut-off value.Conclusion:Color Doppler ultrasound combined with thyroid hormone levels for diagnosing hyperthyroidism and GD of the pregnant women has higher value.