TRAb、TSH、IFN-γ和IL-17水平变化在甲状腺功能亢进患者诊断中的应用

Application of TRAb,TSH,IFN-γand IL-17 levels in the diagnosis of patients with hyperthyroidism

目的探讨促甲状腺激素受体抗体(TRAb)、促甲状腺激素(TSH)及干扰素(IFN)-γ、白细胞介素(IL)-17水平变化在甲状腺功能亢进(简称甲亢)患者诊断中的应用价值。方法选择2020年1-7月该院收治的甲亢患者320例作为甲亢组,选择该院的体检健康者180例作为对照组,采用化学发光法检测游离三碘甲状腺原氨酸(FT 3)、游离甲状腺素(FT 4)和TSH水平,采用酶联免疫吸附试验检测血清IFN-γ和IL-17水平,采用电化学法检测TRAb水平;采用Pearson相关分析上述指标与甲亢的相关性;采用多因素Logistic回归分析影响甲亢发生的因素;采用受试者工作特征(ROC)曲线评估TRAb、IFN-γ、IL-17的诊断价值。结果甲亢组血清TSH水平低于对照组,FT 3、FT 4、TRAb水平高于对照组,差异有统计学意义(P<0.05)。甲亢组FT 3、FT 4、TSH、TRAb的阳性率高于对照组,差异有统计学意义(P<0.05)。甲亢组血清IFN-γ水平低于对照组,血清IL-17水平高于对照组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,TRAb、IFN-γ、IL-17水平,以及TRAb阳性率与甲亢存在相关性(r=0.683、0.711、0.674、-0.634,P<0.05)。多因素Logistic回归分析结果显示,TRAb、IFN-γ、IL-17水平,以及TRAb阳性率均为导致甲亢发生的影响因素(P<0.05)。ROC曲线结果显示,TRAb、IL-17、IFN-γ联合诊断甲亢的曲线下面积为0.729。结论在甲亢患者中TRAb水平较高,与甲亢的发生密切相关,TRAb联合IL-17、IFN-γ是诊断甲亢的重要指标。

Objective To investigate the application of thyroid-stimulating hormone receptor antibody(TRAb),thyroid-stimulating hormone(TSH),interferon(IFN)-γ,and interleukin(IL)-17 in the diagnosis value of patients with hyperthyroidism.Methods From January to July 2020,320 patients with hyperthyroidism admitted to this hospital were selected as the hyperthyroidism group,and 180 healthy patients from the hospital were selected as the control group.Chemiluminescence was used to detect the levels of free triiodothyronine(FT 3),free thyroxine(FT 4)and TSH,enzyme-linked immunosorbent assay was used to detect serum IFN-γand IL-17 levels,and electrochemical method was used to detect TRAb level.Pearson correlation analysis was used to analyze the correlation between the above indicators and hyperthyroidism.Multivariate Logistic regression analysis was used to analyze the factors affecting the occurrence of hyperthyroidism.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of the TRAb,IFN-γ,IL-17.Results The serum TSH level of the hyperthyroidism group was lower than that of the control group,and the levels of FT 3,FT 4,and TRAb were higher than that of the control group,the differences were statistically significant(P<0.05).The positive rates of FT 3,FT 4,TSH and TRAb in the hyperthyroidism group were higher than those in the control group,and the differences were statistically significant(P<0.05).The level of serum IFN-γin the hyperthyroidism group was lower than that of the control group,and the level of serum IL-17 was higher than that of the control group,the differences were statistically significant(P<0.05).Pearson correlation analysis showed that the positive rate of TRAb,the levels of TRAb,IFN-γ,IL-17 and hyperthyroidism were correlated(r=0.683,0.711,0.674,-0.634,P<0.05).The results of multivariate Logistic regression analysis showed that the positive rate of TRAb,the levels of TRAb,IFN-γ,and IL-17 were all influential factors leading to the occurrence of hyperthyroidism(P<0.05).ROC curve results showed that the area under the curve for the combined diagnosis of hyperthyroidism by TRAb,IL-17,and IFN-γwas 0.729.Conclusion In patients with hyperthyroidism,the level of TRAb is relatively high,which is closely related to the occurrence of hyperthyroidism.TRAb combined with IL-17 and IFN-γare important indicators for the diagnosis of hyperthyroidism.