吉林大学学报(医学版) ›› 2017, Vol. 43 ›› Issue (06): 1199-1203.doi: 10.13481/j.1671-587x.20170624

• 临床研究 • 上一篇    下一篇

白细胞亚型和甲状腺功能检测在甲状腺毒症鉴别诊断中的意义

时猛1, 陈雪芹2, 孔丽丽1, 金青松1, 张凌云1, 金勇君1   

  1. 1. 滨州医学院烟台附属医院内分泌科, 山东 烟台 264100;
    2. 山东省临沂市中医院内分泌科, 山东 临沂 276003
  • 收稿日期:2017-04-26 出版日期:2017-11-28 发布日期:2017-12-01
  • 通讯作者: 金勇君,教授,硕士研究生导师(Tel:0535-4770703,E-mail:endojin@126.com) E-mail:endojin@126.com
  • 作者简介:时猛(1980-),男,山东省临沭县人,在读医学硕士,主要从事甲状腺疾病治疗方面的研究。
  • 基金资助:
    山东省科技厅中青年科学家科研奖励基金资助课题(BS2010YY002);山东省科技厅自然科学基金资助课题(ZR2015HL029)

Significance of leukocyte subtypes and thyroid function tests in differential diagnosis of thyrotoxicosis

SHI Meng1, CHEN Xueqin2, KONG Lili1, JIN Qingsong1, ZHANG Lingyun1, JIN Yongjun1   

  1. 1. Department of Endocrinology, Yantai Affiliated Hospital, Binzhou Medical University, Yantai 264100, China;
    2. Department of Endocrinology, Chinese Medicine Hospital of Linyi City, Linyi 276003, China
  • Received:2017-04-26 Online:2017-11-28 Published:2017-12-01

摘要: 目的:探讨不同甲状腺毒症患者血白细胞亚型和甲状腺功能的差异,阐明血白细胞亚型和甲状腺功能检测鉴别诊断Graves病甲状腺毒症和破坏性甲状腺毒症的实用意义。方法:回顾性分析经临床和实验室检查确诊的33例Graves病患者和30例破坏性甲状腺毒症患者的中性粒细胞(Ne)、淋巴细胞(Ly)、嗜碱性粒细胞(Ba)、嗜酸性粒细胞(Eo)、单核细胞(Mo)、血清游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)和甲状腺刺激激素(TSH)值;采用受试者工作曲线(ROC)评价有统计学意义的检查指标对Graves病和破坏性甲状腺毒症的鉴别诊断价值。结果:Graves病组患者血清Eo、FT4与FT3值和改良后的数据Eo/Mo、Eo×FT3/Mo均明显高于破坏性甲状腺毒症组(P < 0.05),而TSH和Mo值低于破坏性甲状腺毒症组(P < 0.05)。ROC曲线分析,Eo、Eo/Mo、Eo×FT3/Mo在2种疾病鉴别诊断中的灵敏度和特异度良好,最佳诊断界点分别为1.54、0.34和3.94。结论:Eo、Mo、TSH、FT3、FT4、Eo/Mo和Eo×FT3/Mo均可作为鉴别诊断2种疾病的依据,其中Eo、Eo/Mo和Eo×FT3/Mo对于Graves病与破坏性甲状腺毒症的鉴别诊断实用意义较大。

关键词: 白细胞亚型, 甲状腺功能, 甲状腺毒症, 鉴别诊断

Abstract: Objective:To explore the differences of leukocyte subtypes and thyroid function of the patients with different thyrotoxicosis diseases, and to clarify the practical significance of leukocyte subtypes and thyroid function tests in the differential diagnosis of Graves disease thyrotoxicosisand destructive thyrotoxicosis. Methods:A total of 33 patients with Graves disease thyrotoxicosis and 30 patients with destructive thyrotoxicosis confirmed by clinical and laboratory examination were selected;the levels of neutrophils (Ne), lymphocyte (Ly), basophils (Ba), eosinophil (Eo) and mononuclear cells (Mo), serum free thyroxine (FT4), three free iodine thyroid former glycine (FT3),and thyroid stimulating hormone (TSH) of the patients in two groups were analyzed and the receiver operator characteristic curve (ROC) was used to evaluate the values of the indicators with statastical significance in the differential diagnosis of Graves disease thyrotoxicosis and destructive thyrotoxicosis. Results:The levels of serum Eo,FT4 and FT3, and the modified data Eo/Mo, Eo×FT3/Mo of the patients in Graves disease thyrotoxicosis group were significantly higher than those in destructive thyrotoxicosis group(P<0.05);the levels of TSH and Mo of the patients were lower than those in destructive thyrotoxicosis group (P<0.05).The ROC curve analysis results showed that the sensitivities and specificities of Eo, Eo/Mo, Eo×FT3/Mo in the differential diagnosis of two diseases were good, and the best diagnostic boundaries were 1.54, 0.34, and 3.94. Conclusion:Eo, Mo, TSH, FT3, FT4, Eo/Mo, and EoxFT3/Mo could be regarded as the basis in the differential diagnosis of Graves disease thyrotoxicosis and destructive thyrotoxicosis, and the practical significances of Eo, Eo/Mo, and Eo×FT3/Mo in the differential diagnosis of Graves disease thyrotoxicosis and destructive thyotoxicosis are bigger.

Key words: thyroid function, leukocyte subtypes, thyrotoxicosis, differential diagnosis

中图分类号: 

  • R581.1