摘要
目的探讨甲状腺功能亢进症(甲亢)患者血清生长分化因子15(GDF-15)、胎球蛋白A水平变化的意义及与甲状腺功能指标促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺激素(FT_(4))的相关性。方法选取2019年1月至2021年3月河北省邯郸市第一医院收治的62例甲亢患者作为观察组,另选取同期体检健康者56例为对照组。甲亢患者给予甲巯咪唑治疗3个月。观察比较2组基线血清TSH、FT_(3)、FT_(4)、GDF-15、胎球蛋白A水平,分析甲亢患者治疗前与治疗1、3个月时相关指标血清水平变化,分析甲亢患者血清GDF-15、胎球蛋白A水平与TSH、FT_(3)、FT_(4)的相关性,评估GDF-15、胎球蛋白A对甲亢的预测价值。结果观察组血清FT_(3)、FT_(4)、GDF-15、胎球蛋白A水平高于对照组,TSH水平低于对照组,差异均有统计学意义(均P<0.05)。与治疗前比较,甲亢患者治疗1、3个月时FT_(3)、FT_(4)、GDF-15、胎球蛋白A水平降低,TSH水平升高(P<0.05)。Pearson相关性分析结果显示,GDF-15水平与TSH水平呈负相关(r=-0.893,P<0.001),与FT_(3)、FT_(4)水平均呈正相关(r=0.895、0.997,均P<0.001);胎球蛋白A水平与TSH水平呈负相关(r=-0.958,P<0.001),与FT_(3)、FT_(4)水平均呈正相关(r=0.954、0.884,均P<0.001)。受试者工作特征曲线分析结果显示,血清GDF-15、胎球蛋白A预测甲亢的曲线下面积分别为0.763(95%置信区间:0.674~0.852)、0.782(95%置信区间:0.695~0.869);GDF-15预测甲亢的敏感度为82.3%、特异度为69.6%,胎球蛋白A预测甲亢的敏感度为79.0%、特异度为76.8%。结论GDF-15、胎球蛋白A水平与TSH、FT_(3)、FT_(4)水平存在相关性,GDF-15、胎球蛋白A水平变化在甲亢发生发展及临床辅助预测中具有重要作用。
Objective To investigated the changes in serum growth differentiation factor-15(GDF-15)and fetuin-A levels in patients with hyperthyroidism and their relationship with thyroid stimulating hormone(TSH),free triiodothyronine(FT_(3))and free thyroid hormone(FT_(4)).Methods A total of 62 patients with hyperthyroidism admitted to Handan First Hospital,Hebei Province from January 2019 to March 2021 were selected as the observation group,and 56 patients with healthy physical examination during the same period were selected as the control group.The patients with hyperthyroidism were treated with thiamazole for 3 months.The baseline serum levels of TSH,FT_(3),FT_(4),GDF-15 and fetuin-A of the two groups were compared,and the changes of indexes were analyzed in patients with hyperthyroidism before treatment and at 1 and 3 months of treatment.The relationship of serum GDF-15 and fetuin-A levels with TSH,FT_(3),FT_(4) in patients with hyperthyroidism,and evaluate the predictive value of GDF-15 and fetuin-A for hyperthyroidism were analyzed.Results The serum levels of FT_(3),FT_(4),GDF-15 and fetuin-A in the observation group were higher than those in the control group,and the level of TSH was lower than that in the control group(all P<0.05).The levels of FT_(3),FT_(4),GDF-15 and fetuin-A in patients with hyperthyroidism at 1 and 3 months of treatment were lower than those before treatment,and the level of TSH was higher than that before treatment(all P<0.05).Pearson correlation analysis showed that GDF-15 was negatively correlated with TSH(r=-0.893,P<0.001),and positively correlated with FT_(3) and FT_(4)(r=0.895,0.997,both P<0.001);fetuin-A was negatively correlated with TSH(r=-0.958,P<0.001),and positively correlated with FT_(3) and FT_(4)(r=0.954,0.884,both P<0.001).Receiver operating characteristic curve analysis showed that the areas under the curve of serum GDF-15 and fetuin-A for predicting hyperthyroidism were 0.763(95%confidence interval:0.674-0.852)and 0.782(95%confidence interval:0.695-0.869);the sensitivity and s
作者
王丽萍
牛尚梅
刘云
柴巧英
史冬丹
李欣欣
胡新磊
Wang Liping;Niu Shangmei;Liu Yun;Chai Qiaoying;Shi Dongdan;Li Xinxin;Hu Xinlei(Department of Endocrinology,Handan First Hospital,Hebei Province,Handan 056002,China;Department of Cardiology,Handan First Hospital,Hebei Province,Handan 056002,China)
出处
《中国医药》
2022年第7期1020-1023,共4页
China Medicine
基金
河北省医学科学研究课题计划(20210232)。
