Graves病患者合并胸腺增生的影响因素分析

Analysis of influencing factors in patients with Graves'disease complicated with thymic hyperplasia

目的:分析Graves病患者合并胸腺增生的相关影响因素。方法:收集2018年11月—2020年11月临床确诊的Graves病患者100例,依据胸部CT结果分为两组:合并胸腺增生51例,未合并胸腺增生49例。分析两组年龄、病程、白细胞、中性粒细胞、肝功能、游离甲状腺功能(甲功)、促甲状腺素受体抗体(TRAb)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)等相关指标。结果:本研究中Graves病合并胸腺增生发生率为51%;Graves病合并胸腺增生组与未合并胸腺增生组相比,年龄较小,谷丙转氨酶(ALT)、FT3、FT4水平较高(t=-4.216,Z=-2.321、-2.837、2.633,均P<0.05);单因素Logistic回归分析结果提示,年龄、FT3、FT4均与Graves病合并胸腺增生相关(OR=0.942、1.046、1.040,95%CI:0.913~0.972、1.010~1.082、1.008~1.073,均P<0.05);多因素Logistic回归分析结果提示,年龄是评价Graves病合并胸腺增生的独立危险因素(OR=0.946,95%CI:0.917~0.977,P<0.05);年龄预测Graves病伴胸腺增生的受试者工作特征曲线(ROC曲线)下面积为0.734(95%CI:0.632~0.836),截断值为48.5岁,灵敏性72.5%,特异性75.5%(P<0.01)。结论:Graves病合并胸腺增生与TRAb水平无相关性,但与年龄呈负相关。

Objective:To analyze the related influencing factors in patients with Graves'disease complicated with thymic hyperplasia.Methods:A total of 100 patients with Graves'disease who were clinically diagnosed from November 2018 to November 2020 were enrolled in this study and divided into two groups based on chest CT findings:51 cases with thymic hyperplasia;49 cases without thymic hyperplasia.The age,course of disease,white blood cells,neutrophils,liver function,free thyroid function,TRAb,TGAb,TPOAb and other related indicators of the two groups of patients were analyzed.Results:In the study,the incidence of Graves'disease with thymic hyperplasia was 51%.Compared with the group without thymic hyperplasia,the age was younger in the group with thymic hyperplasia,while the ALT,FT3 and FT4 levels were higher,the difference was statistically significant(t=-4.216,Z=0.020,-2.837,2.633,all P<0.05).The univariate Logistic regression analysis showed that age of onset,FT3,FT4 were all related to Graves'disease with thymic hyperplasia(OR=0.942,1.046,1.040,95%CI:0.913-0.972,1.010-1.082,1.008-1.073,all P<0.05).The multivariate Logistic regression analysis showed that the age of onset was an independent risk factor for the evaluation of Graves'disease with thymic hyperplasia(OR=0.946,95%CI:0.917-0.977,P<0.05).The area under the ROC curve of age prediction of Graves'disease with thymic hyperplasia was 0.734(95%CI:0.632-0.836),the cut-off value was 48.5 years old,the sensitivity was 72.5%,the specificity was 75.5%(P<0.01).Conclusion:There is no relationship between thymic hyperplasia in patients with Graves'disease and TRAb level,but the age of onset is negatively correlated with thymic hyperplasia.