摘要
目的探讨甲功五项联检法在甲状腺功能障碍诊断中的应用效果。方法对2022年1月—2023年1月在济南市中西医结合医院就诊的140例甲状腺功能障碍患者的临床资料进行收集,根据患者甲状腺功能分为甲状腺功能亢进(甲亢)组(60例)和甲状腺功能减退(甲减)组(80例);另外选择同期在该院进行健康体检的100名健康志愿者,将其设为对照组。采用电化学发光免疫分析法对所有受检者血清样本进行甲功五项检测,包括促甲状腺激素(TSH)、总三碘甲状腺原氨酸(TT_(3))、总四碘甲状腺原氨酸(TT_(4))、游离三碘甲状腺原氨酸(FT_(3))、游离四碘甲状腺原氨酸(FT_(4))。比较甲亢组、甲减组与对照组的血清TSH、TT_(3)、TT_(4)、FT_(3)、FT_(4)水平,并比较在甲状腺功能障碍诊断中应用甲功五项指标单独与联合检测得出的诊断结果。结果甲减组的血清TSH水平明显高于甲亢组和对照组[TSH(mU/L):6.85±2.24比0.38±0.12、2.91±0.83,均P<0.05],且甲亢组的血清TSH水平明显低于对照组(P<0.05)。甲亢组的血清TT_(3)、TT_(4)、FT_(3)、FT_(4)水平均明显高于甲减组和对照组[TT_(3)(nmoL/L):5.74±1.39比0.93±0.30、2.35±0.74,TT_(4)(nmoL/L):265.40±43.86比53.18±6.37、136.49±21.40,FT_(3)(pmo L/L):8.94±2.47比1.89±0.61、5.02±1.45,FT_(4)(pmo L/L):31.57±6.14比9.04±2.75、17.48±4.29,均P<0.05],且甲减组的血清TT_(3)、TT_(4)、FT_(3)、FT_(4)水平均明显低于对照组(均P<0.05)。在甲状腺功能障碍诊断中,甲功五项联检的各项效能指标(灵敏度、特异度、准确度、阳性预测值、阴性预测值)均明显高于各指标单独检测。结论甲状腺功能障碍患者的甲功五项指标表达均出现异常,甲亢和甲减患者的甲功五项指标水平存在明显差异,对甲状腺功能障碍进行临床诊断时,甲功五项联检法具有较高的应用价值,可准确地鉴别诊断甲亢和甲减。
Objective To explore the clinical efficacy of thyroid function five items joint examination in the diagnosis of thyroid dysfunction.Methods From January 2022 to January 2023,the clinical data of 140 patients with thyroid dysfunction in Jinan Integrated Traditional Chinese and Western Medicine Hospital were collected.According to their thyroid function,the patients were divided into hyperthyroidism group(60 cases)and hypothyroidism group(80 cases).The 100 healthy volunteers undergoing physical examination in the hospital during the same period were selected as control group.Electrochemiluminescence immunoassay was used to perform thyroid function five items on serum samples of all subjects,including thyroid stimulating hormone(TSH),total triiodothyronine(TT_(3)),total tetraiodothyronine(TT_(4)),free triiodothyronine(FT_(3))and free tetraiodothyronine(FT_(4)).The serum levels of TSH,TT_(3),TT_(4),FT_(3) and FT_(4) in hyperthyroidism group,hypothyroidism group and control group were compared,and the diagnostic results obtained by single and combined detection of thyroid function five items in the diagnosis of thyroid dysfunction were compared.Results The serum TSH level in hypothyroidism group was significantly higher than those in hyperthyroidism group and control group[TSH(mU/L):6.85±2.24 vs.0.38±0.12,2.91±0.83,both P<0.05],and the serum TSH level in hyperthyroidism group was significantly lower than that in control group(P<0.05).The levels of serum TT_(3),TT_(4),FT_(3) and FT_(4) in hyperthyroidism group were significantly higher than those in hypothyroidism group and control group[TT_(3)(nmoL/L):5.74±1.39 vs.0.93±0.30,2.35±0.74;TT_(4)(nmoL/L):265.40±43.86 vs.53.18±6.37,136.49±21.40;FT_(3)(pmoL/L):8.94±2.47 vs.1.89±0.61,5.02±1.45;FT_(4)(pmoL/L):31.57±6.14 vs.9.04±2.75,17.48±4.29,all P<0.05],the serum levels of TT_(3),TT_(4),FT_(3) and FT_(4) in hypothyroidism group were significantly lower than those in control group(all P<0.05).In the diagnosis of thyroid dysfunction,the efficacy indicators(including sensitivity,specificity,accuracy,positive predictive value and negative predictive value)of the combined detection of thyroid function five items were significantly higher than those of individual detection of each indicator.Conclusions The expression levels of five indicators of thyroid function in patients with thyroid dysfunction are abnormal,and there are significant differences in the levels of five indicators between hyperthyroidism group and hypothyroidism group.When diagnosing thyroid dysfunction clinically,the combined detection of the five indicators of thyroid function has good application value and could accurately distinguish and diagnose hyperthyroidism and hypothyroidism.
作者
孔凡翠
Kong Fancui(Department of Clinical Laboratory,Jinan Integrated Traditional Chinese and Western Medicine Hospital,Jinan 271199,Shandong,China)
出处
《实用检验医师杂志》
2023年第4期422-425,共4页
Chinese Journal of Clinical Pathologist
