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自由甲状腺激素与甲状腺刺激激素的比例:格雷夫斯病的潜在诊断标记物
Norashidah Binti Rahmat1, Tuan Salwani Tuan Ismail2, Mohd Zakwan Bin Md Muslim3
1Chemical Pathology Unit, Department of Pathology, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia.
概括
自由甲状腺激素与甲状腺刺激激素 (FT4/TSH) 的比率可以帮助诊断当抗体检测不可用时的格雷夫斯病. 这种可访问的标志物显示出高特异性和积极的预测价值,可及时诊断和改善患者的治疗结果.
科学领域:
- 内分泌学 在内分泌学.
- 临床诊断 临床诊断 临床诊断
- 生物化学 生化学
背景情况:
- 格雷夫斯病 (GD) 是甲状腺功能障碍的主要原因.
- 甲状腺刺激激素受体自身抗体 (TRAb) 测试是针对GD的,但其可访问性有限.
- 需要替代的诊断标记物,以促进及时的GD诊断和治疗.
研究的目的:
- 为了评估自由甲状腺素与甲状腺刺激激素 (FT4/TSH) 的比率的诊断准确性.
- 为了区分格雷夫斯病 (GD) 和其他非格雷夫斯病 (NGD) 甲状腺功能障碍.
主要方法:
- 351名甲状腺功能过高患者 (2021-2023) 的回顾性研究.
- 基于内分泌学家诊断的GD和NGD组的分类.
- 使用接收器操作特征 (ROC) 曲线分析分析TSH,FT4和FT4/TSH比率的分析.
主要成果:
- 与NGD患者相比,患有GD的患者表现出明显更高的FT4和FT4/TSH比率和更低的TSH水平 (P < 0.001).
- 一个FT4/TSH比率切断值13948.98 pmol/mIU显示了99.4%的特异性和92.31%的积极预测值.
- FT4/TSH比率的曲线下的面积 (AUC) 是0.740.
结论:
- FT4/TSH比率是Graves病的一个有希望的,可访问的诊断标志物.
- 它的高特异性和PPV可以帮助及时诊断,特别是在TRAb测试有限的地方.
- 建议在较大的群体中进一步验证,以确认其临床实用性.
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