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

doi:10.13481/j.1671-587x.20170624

Abstract

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

CLC Number:

R581.1

SHI Meng, CHEN Xueqin, KONG Lili, JIN Qingsong, ZHANG Lingyun, JIN Yongjun. Significance of leukocyte subtypes and thyroid function tests in differential diagnosis of thyrotoxicosis[J].Journal of Jilin University Medicine Edition, 2017, 43(06): 1199-1203.

References

[1] 陈治龙,霍克新. 甲亢合并桥本氏甲状腺炎24例治疗体会[J].吉林医学,2011,17(1):22-23.
[2] 易芳,王晓书,陈淑文. 彩超在诊断桥本氏甲状腺炎伴亚临床甲状腺功能减退中的应用价值[J].西部医学,2012,24(1):144-145,148.
[3] 吕祝英,雷志锴,楼军. 超声弹性成像与常规超声对桥本氏甲状腺炎及Graves病的鉴别诊断价值分析[J].中国现代医生,2016,54(26):109-112.
[4] 毛学文. 284例甲状腺毒症病因分析[J]. 中国民族民间医药,2010,6(5):56-57.
[5] 马军. 甲状腺激素T3对骨髓单个核细胞增殖及凋亡的影响[D]. 郑州:郑州大学,2010.
[6] 邹大进,李娟. 甲状腺功能亢进症伴粒细胞减少的诊断与处理[J]. 中国实用内科杂志,2006,26(9):645-646.
[7] Weetman AP. Autoimmune thyroid disease[J]. Autoimmunity,2004,37(4):337-340.
[8] 王家伦. Graves'病合并粒细胞减少症的临床分析[J]. 实用医技杂志,2003,10(12):1466-1467.
[9] 刘新民. 使用内分泌诊疗手册[M]. 北京:人民军医出版社,1996:621-622.
[10] Vaiana R, Cappelli C, Rerini P, et al. I-Iyperthyroidism and concurrent thyroid cancer[J]. Tumori,1999,85(4):247-252.
[11] Cooper DS, Ladenson PW, Nisula BC, et al. Familial thyroid hormone resistance[J]. Metabolism,1982,31(5):504-509.
[12] Kawa MP, Grymula K, Paczkowska E,et al. Clinical relevance of thyroid dysfunction on human haematopoiesis-biochemical and molecular studies[J].Eur J Endocrinol,2010,162(2):295-305.
[13] 高绪文,李继莲. 甲状腺疾病[M]. 北京:人民卫生出版社,1999:18-19.
[14] 廖永日. 进行血清T3、T4检测对弥漫性毒性甲状腺肿和亚急性甲状腺炎进行鉴别诊断的效果研究[J]. 当代医药论丛,2016,14(5):131-132.
[15] 马萍. Craves病患者血清TRAb的检测及其临床意义[D]. 石家庄:河北医科大学,2010.
[16] 张健,刘彦明,管振祺,等. 甲状腺毒症患者单个核细胞Foxp3检测分析[J]. 微循环学杂志,2015,25(2):49-51.
[17] 苟静,靳瑾,阿布力克木·吐尔地. 血清T3/T4值对Graves病甲亢与亚甲炎引起的甲状腺毒症的分析[J]. 新疆医科大学学报,2010,33(10):1229-1231.
[18] Nishihara E, Ohye H, Amino N, et al. Clinical characteristics of 852 patients with subacute thyroiditis before treatment[J]. Intern Med,2008,47(8):725-729.
[19] 宁宁,张杰,何长武,等. T3/T4值、TRAb和ALP在育龄期女性甲状腺毒症中的鉴别价值[J].西北国防医学杂志,2015,36(9):585-588.
[20] 蔡梅,郭华林. 血清TpoAb、TRAb检测在亚急性甲状腺炎与Graves'病鉴别诊断中的意义[J]. 山东医药,2013,53(39):62-63.
[21] 吴盛海,魏振利. T3/T4、TSH、AKP对无痛性甲状腺炎及Graves'病的鉴别诊断价值[J].放射免疫学杂志,2006,19(1):71-72.

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

PDF (PC)

Like

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 4

Metrics

Comments

Recommended 0

[1]	LIN Yu, LIU Meihan, SHI Weidong, SUN Zhixia, CHEN Enqi, ZHANG Xin, WANG Zhiyuan. Application of ultrasonography in diagnosis and differential diagnosis of Takayasu arteritis [J]. Journal of Jilin University Medicine Edition, 2017, 43(06): 1268-1271.
[2]	GU Sanwei, MA Hongshuang, ZHAO Ling, JIANG Zhenyu. Analysis on clinical characteristics of PM/DM combined with thyroid disease [J]. Journal of Jilin University Medicine Edition, 2016, 42(05): 999-1004.
[3]	CHEN Qian,QI Chuan-wang,ZHANG Hui,ZHANG Peng,WU Rui-hong,CHI Xiu-mei,YU Ge,PAN Yu,NIU Jun-qi. Thyroid function of patients with chronic hepatitis C after antiviral treatment: dynamic changes,prognosis and influencing factors [J]. Journal of Jilin University Medicine Edition, 2014, 40(03): 641-644.
[4]	SUN Jing-chun,WEI Qian,WU Yue-ting,REN Zhi-xing,REN Shu-ping,CHEN Gui-qiu,ZOU Yun,YANG Ying-ying. Effects of high dose of vitamin E on oxidative stress and 　thyroid functions of rats [J]. Journal of Jilin University Medicine Edition, 2014, 40(02): 281-284.