摘要
目的:探讨利用T3/T4、T3、敏感促甲状腺激素(sTSH)和甲状腺血流指标区别Graves’病(GD)甲状腺功能亢进(甲亢)和吸131I率低性甲亢(非GD甲亢)的价值。方法:分别检测50例GD患者和35例非GD甲亢患者(亚急性甲状腺炎11例、桥本氏甲状腺炎20例、产后甲状腺炎3例、药物性甲亢1例)的吸131I率和T3、T4、T3/T4、FT3、FT4、FT3/FT4、sTSH,并用彩色多普勒血流显像(CDFI)测定舒张期甲状腺上动脉(STA)内径(D)和STA的收缩期最高血流速度(Vmax)、舒张末期血流速度(Vmin)以及阻力指数(RI)。结果:GD组的T3/T4、T3、FT4、FT3和STA的D、Vmax和Vmin明显高于非GD组,GD组中sTSH<0.005mIU/L者占36%(18/50);而非GD组只占2.86%(1/35)。以非GD组的T3/T4、T3、Vmax和D的平均值+2个标准差以及sTSH=0.005mIU/L为分界点,诊断GD甲亢的敏感性约为33%～47%,特异性达93%～100%。结论:与非GD组比较,GD患者的甲状腺分泌的T3更多,TSH更低,甲状腺血流更丰富。选取T3/T4、T3、sTSH、Vmax和D的特定数值对区别两类甲亢很有帮助。
Objective： To detect T3/T4, T3, sTSH and parameters of thyroid blood flow of Graves＇ disease （GD） and lower iodine uptake hyperthyroidism （non-GD） and discuss those values in the differentiate diagnosis of the two diseases. Methods： Thyroid ＇hi uptake, T3, T4, T3/T4, FT3, FT4, FT3/FT4 and sensitive TSH （sTSH） were detected in 50 patients with GD and 35 patients with non-GD （11 cases with subacute thyroiditis, 20 cases with Hashimoto＇s thyroiditis, 3 cases with post partum thymiditis and 1 case with thyrotoxicosis factitia）. Diameter （D） of superior thyroid artery （STA） maximal velocity （Vmax）, minimal velocity （Vmin） and resistance index （RI） were examined by CDFI. Results： The levels of T3/T4, T3, FT3, FT4, Vmax, Vmin and D of STA in GD group were higher than those in non-GD group. The percentage of sTSH 〈 O.005mIU/L was 36% （18/50） in GD group and that was 2.86% （1/35） in non-GD group. The mean plus 2 standard deviation of T3/T4, T3, Vmax and D and sTSH=0.005 mIU/L were used as boundary, and the diagnostic sensitivity and specificity for GD were 33%-47% and 93%-100% respectively. Conclusion： Comparing with non-GD group, much more T3 is secreted from thyroid, TSH cells in pituitary gland is depressed more deeply and thyroid blood flow is more abundant in patients with GD. T3/T4, T3, sTSH, Vmax and D may be used as tool to diffentiate GD from lower iodine uptake hyperthyroidism.
出处
《天津医药》
CAS
北大核心
2007年第3期164-166,共3页
Tianjin Medical Journal
基金
深圳市科技计划项目(项目编号:200603032)
