血清促甲状腺激素、游离三碘甲状腺原氨酸、游离甲状腺素在脑梗死患者血管狭窄中的诊断效能

Diagnostic efficiency of serum thyroid stimulating hormone,free triiodothyronine and serum free thyroxine in vascular stenosis of patients with cerebral infarction

目的:分析血清促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))在脑梗死患者血管狭窄中的诊断效能。方法:回顾性分析2022年3月至2023年3月该院收治的100例脑梗死患者的临床资料,并根据北美症状性动脉内膜切除术研究协助组(NASCET)狭窄测量标准,将不同脑血管狭窄程度患者分为重度狭窄组(n=48)与中轻度狭窄组(n=52),另选取100名同期健康体检者的临床资料,设为对照组。比较三组血清TSH、FT_(3)、FT_(4)水平;采用双变量相关性tau-(K)分析血清TSH、FT_(3)、FT_(4)水平与脑梗死患者血管狭窄程度的相关性;并绘制受试者工作特征(ROC)曲线分析血清TSH、FT_(3)、FT_(4)水平单项及联合检测对脑梗死患者血管狭窄程度的诊断效能。结果:重度狭窄组TSH、FT_(4)水平均高于中轻度狭窄组、对照组,且中轻度狭窄组高于对照组,FT_(3)水平低于中轻度狭窄组、对照组,且中轻度狭窄组低于对照组,差异有统计学意义(P<0.05);双变量相关性tau-(K)分析结果显示,血清TSH、FT_(4)水平与脑梗死患者血管狭窄程度呈正相关(r>0,P<0.05),血清FT_(3)水平与脑梗死患者血管狭窄程度呈负相关(r<0,P<0.05);ROC曲线结果显示,血清TSH、FT_(3)、FT_(4)水平单项及联合检测诊断脑梗死患者脑血管狭窄的AUC分别为0.815、0.810、0.815、0.895,且联合检测的诊断效能高于三者单项检测的诊断效能。结论:血清TSH、FT_(4)水平与脑梗死患者血管狭窄程度呈正相关,血清FT_(3)水平与脑梗死患者血管狭窄程度呈负相关;血清TSH、FT_(3)、FT_(4)水平单项及联合检测诊断脑梗死患者血管狭窄程度的效能高于三者单项检测的诊断效能。

Objective:To analyze diagnostic efficiency of serum thyroid stimulating hormone(TSH),free triiodothyronine(FT_(3))and serum free thyroxine(FT_(4))in vascular stenosis in patients with cerebral infarction.Methods:The clinical data of 100 patients with cerebral infarction admitted to this hospital from March 2022 to March 2023 were retrospectively analyzed.According to the north American symptomatic carotid endarterectomy(NASCET)stenosis measurement criteria,these patients with different degrees of cerebrovascular stenosis were divided into severe stenosis group(n=48)and mild stenosis group(n=52).The clinical data of 100 healthy subjects were chosen and they were set as the control group.The serum TSH,FT_(3) and FT_(4) levels were compared between the three groups of subjects.The correlations among the serum TSH,FT_(3),FT_(4) levels and the degree of vascular stenosis in the patients with cerebral infarction were analyzed by bivariate correlation tau-(K).The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficiencies of the serum TSH,FT_(3) and FT_(4) levels in the degree of vascular stenosis in the patients with cerebral infarction.Results:The levels of TSH and FT_(4) in the severe stenosis group were higher than those in the mild stenosis group and the control group,and those in the mild stenosis group were higher than those in the control group;the level of FT_(3) was lower than that in the mild stenosis group and the control group,and that in the mild stenosis group was lower than that in the control group;and the differences were statistically significant(P<0.05).The bivariate correlation tau-(K)showed that the serum TSH and FT_(4) levels were positively correlated with the degree of vascular stenosis(r>0,P<0.05),while the FT_(3) level was negatively correlated with the degree of vascular stenosis in patients with cerebral infarction(r<0,P<0.05).ROC curve results showed that the AUC of serum TSH,FT_(3),FT_(4) and combined detection for diagnosing cerebrovascular stenosis in patients with cerebral infarction were 0.815,0.810,0.815 and 0.895,respectively,and the diagnostic efficacy of combined detection was higher than that of the three single detection.Conclusions:The serum TSH and FT_(4) levels are positively correlated with the degree of vascular stenosis in the patients with cerebral infarction,while the serum FT_(3) level is negatively correlated with the degree of vascular stenosis The efficiency of combined detection of the serum TSH,FT_(3) and FT_(4) levels in the diagnosis of vascular stenosis in the patients with cerebral infarction ss higher than that of single detection of the three.