甲功五项对甲状腺功能紊乱的诊断价值及临床意义研究

付玉华　王瑞清

【摘要】 目的：探討甲功五项对甲状腺功能紊乱的诊断价值及临床意义，旨为临床甲状腺疾病的诊治提供理论基础。方法：选取2015年2月-2017年2月就诊于本院内分泌科的甲状腺功能亢进患者为甲亢组和甲状腺功能减退患者为甲减组，每组90例，选取同期健康体检患者100例作为对照组，检测所有研究对象的血清游离三碘甲状腺氨酸（FT3）、游离甲状腺素（FT4）、三碘甲状腺原氨酸（T3）、甲状腺素（T4）、促甲状腺激素（TSH）。观察对比各组患者甲状腺功能指标的差异，并采用ROC曲线评估各指标对甲亢和甲减的诊断价值。结果：甲亢组的FT3、FT4、T3和T4均高于对照组，而TSH小于对照组，甲减组的FT3、FT4、T3和T4均低于对照组，而TSH高于对照组，差异均有统计学意义（P<0.05）。FT3、FT4、T3、T4和TSH联合检测诊断甲亢的AUC为0.928，高于各指标单用时的0.844、0.825、0.812、0.802和0.788，其敏感性为86%，特异性为100%，而各指标联合诊断甲减的AUC为0.949，高于各指标单用时：FT3为0.821，FT4为0.857，T3为0.789，T4为0.802，TSH为0.870，其敏感性为90%，特异性为94%。结论：FT3、FT4、T3、T4和TSH联合诊断甲亢和甲减的临床诊断价值高于各指标单用时，其诊断敏感性和特异性均可靠，对临床甲状腺功能的评估具有重要意义。

【关键词】 甲状腺功能指标； 促甲状腺激素； 甲亢； 甲减； 诊断价值

Diagnostic Value and Clinical Significance of Five Thyroid Index for Thyroid Function Disorders/FU Yu-hua，WANG Rui-qing.//Medical Innovation of China，2017，14（26）：098-101

【Abstract】 Objective：To investigate the diagnostic value and clinical significance of five thyroid function index for thyroid function disorders.Method：From February 2015 to February 2017，90 patients with hyperthyroidism（hyperthyroidism group） and 90 patients with hypothyroidism（hypothyroidism group） treated in our hospital were selected，and 100 healthy patients were selected as the control group.Serum free three iodine thyroid acid（FT3），free thyroxine（FT4），triiodothyronine（T3），thyroxine（T4），thyroid stimulating hormone（TSH）.The difference of thyroid function indexes of three groups were observed and compared，the diagnostic value of each index in hyperthyroidism and hypothyroidism was evaluated by ROC curve.Result：The FT3，FT4，T3 and T4 of hyperthyroidism group were higher than those of the control group，but TSH was less than that of the control group.FT3，FT4，T3 and T4 of hypothyroidism group were lower than those of the control group，and TSH was higher than that of the control group，the differences were statistically significant（P<0.05）.AUC of FT3，FT4，T3，T4 and TSH combined detected hyperthyroidism diagnosis was 0.928，higher than that of each index single detected（0.844，0.825，0.812，0.802 and 0.788 ），sensitivity was 86%，specificity was 100%，AUC of all indexs combined detected hyperthyroidism diagnosis was 0.949，the specificity was 90%，and the specificity was 94%.Conclusion：The clinical diagnostic value of FT3，FT4，T3，T4 and TSH combined detected hyperthyroidism and hypothyroidism are higher than those of the single index，the diagnostic sensitivity and specificity are reliable，it has an important significance for evaluation of clinical thyroid function.endprint

【Key words】 Thyroid function index； TSH； Hyperthyroidism； Hypothyroidism； Diagnostic value

First-authors address：First Affiliated Hospital of Inner Mongolia University of Science and Technology Baotou Medical College，Baotou 014010，China

doi：10.3969/j.issn.1674-4985.2017.26.025

甲状腺疾病属临床上常见病，其中甲状腺功能亢进或减退均会对机体造成严重影响[1]。甲状腺功能亢进（甲亢）由于甲状腺激素释放过多加速了机体代谢，患者主要表现为食欲旺盛、焦虑和心动过速等[2-4]；而甲状腺功能减退（甲减）是因为甲状腺激素释放过少使机体能力代谢速度减慢，故患者主要表现为食欲和记忆力的减退、怕冷等[5-7]。甲亢和甲减均为甲状腺功能紊乱病症，可严重影响到患者的身心健康[8-10]，因此临床对其诊断治疗值得广大临床研究者予以重视，而如何合理有效地利用甲状腺功能检测方法准确诊断甲状腺疾病是非常有必要和有意义的。本研究拟通过研究临床常用的甲状腺功能五项检测指标对甲状腺疾病的诊断价值，以探讨并找出更加合理有效地甲状腺功能检测方法，旨为临床甲状腺疾病的诊治提供理论基础。……