摘要
【目的】探讨甲状腺超声检查联合甲状腺功能指标在良恶性甲状腺结节中的诊断价值。【方法】选择甲状腺结节患者80例，按照病理学检查结果分为两组：良性甲状腺结节57例为良性组，23例恶性甲状腺结节为恶性组。另选择同期医院健康体检正常者40例作为对照组。比较良恶性组甲状腺结节性质、数量、形态、边界、血流信号、内部回声、钙化灶情况、有无淋巴转移等；分别抽取三组受试者静脉血，检测各组血清总三碘甲状腺原氨酸（TT3）、总甲状腺素（TT4）、三碘甲状原氨酸（T3）、甲状腺素（T4）、促甲状腺激素（TSH）、抗甲状腺球蛋白抗体（TGA）、抗甲状腺过氧化物酶抗体（TPO-Ab）水平并比较。【结果】良性组、恶性组血清TT3、TT4、T3、T4、TGA、TPO-Ab、TSH均显著高于对照组（P〈0．05）；其中恶性组TSH显著高于良性组（P〈0．05）。与良性组比较，恶性组形态不规则、边界不清、回声不均匀、钙化、淋巴肿大所占比例显著增加，血流分级也显著升高，其差异均有统计学意义（P〈0．05）。TSH联合超声检查对恶性甲状腺结节诊断的特异度显著高于TSH单项检查（χ^2=7．048，P=0．000）。【结论】TsH联合超声检查能够显著提高良恶性甲状腺结节的诊断价值，值得临床推广。
[Objective]To explore the clinical value of thyroid ultrasonography combined with thyroid function indexes in the diagnosis of benign and malignant thyroid tumors. [Methods]A retrospective analysis （from January 2013 to February 2015） of 80 cases of thyroid nodules patients were, according to the results of pathological examination, divided into 57 cases of benign thyroid nodules （benign group） and 23 cases of malignant thyroid nodules （malignant group）. Another 40 cases of healthy people in the hospital through physical examinations were selected as the control group. Thyroid nodules were examined by ultrasonography and the thyroid nodules, nature, number, shape, border, blood flow signal, internal echo, and calcification were all recorded. Blood samples were collected from three groups of subjects, and serum levels of TT3 ,TT4 ,T3 ,T4 ,TGA,TPO-Ab,TSH were detected by chemiluminescence method. [Results] The serum TT3, TT4, T3, T4, TGA, TPO-Ab, TSH levels in the benign group and malignant group were significantly higher than the levels in the control group （ P 〈0.05）, and TSH in malignant group was significantly higher than that in benign group （ P 〈0.05）. Compared with the benign group, the tumors in the malignant group had unclear boundaries, uneven echoes, calcification, lymph nodes, and higher blood flow. The differences were statistically significant （ P 〈0.05）. TSH for malignant thyroid nodules critical value of AUC was 0.663, the sensitivity was 0.551, specificity was 40.8 %, TSH combined ultrasound for malignant thyroid nodules critical value of mlU/L was TSH, the sensitivity was 85.7%, specificity was 78.4%, the sensitivity was 1.517. [Conclusion]TSH combined with ultrasound can significantly improve the diagnosis of benign and malignant thyroid nodules, and is worthy of clinical promotion.
出处
《医学临床研究》
CAS
2015年第12期2330-2333,共4页
Journal of Clinical Research
