Wang C, Zhu Y, Zhou L L, Zhao Y Y, Han X Y, Ji L N
Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing 100044, China(is working on Department of Endocrinology, Tangshan People's Hospital, Tangshan 063000, China).
Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing 100044, China.
Zhonghua Nei Ke Za Zhi. 2020 Mar 1;59(3):207-212. doi: 10.3760/cma.j.issn.0578-1426.2020.03.007.
To evaluate the clinical value of the superior thyroid artery peak systolic velocity (STA-PSV) for the differential diagnosis of autoimmune thyrotoxicosis. A total of 301 patients with newly diagnosed thyrotoxicosis and without any anti-thyroid drug intervention were collected from the Department of Endocrinology and Metabolism, Peking University People's Hospital from Jan. 2015 to Oct. 2018. Among them, 241 patients were with Graves' disease (GD) and 60 patients were with autoimmune thyroiditis (AIT). STA-PSV, thyroid function and thyrotropin receptor antibody (TRAb) were determined. A multiple linear regression was used to identify factors associated with STA-PSV. A receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the discriminating ability of STA-PSV to GD. STA-PSV leves in GD group were significantly higher than those in AIT group [61.00 (41.00, 86.50) cm/s vs. 34.50 (25.25, 46.00) cm/s, 0.001]. The ROC curve analysis showed that the AUC was 0.790 (95 0.734-0.845), and 49.5cm/s was the optimal cutoff point for the diagnosis of GD, in which the sensitivity was 64.3% and the specificity was 83.3%. In all patients with thyrotoxicosis, multiple linear regression analyses showed free thyroxine (FT(4)) (β=0.371, 95 0.005-0.010, 0.001) and TRAb (β=0.138, 95 0.001-0.014, 0.035) were positively associated with STA-PSV. The STA-PSV is positively associated with FT(4) and TRAb levels, and it is a helpful marker in differential diagnosis between GD and AIT.
评估甲状腺上动脉收缩期峰值流速（STA-PSV）在自身免疫性甲状腺毒症鉴别诊断中的临床价值。2015年1月至2018年10月，从北京大学人民医院内分泌代谢科收集了301例新诊断的甲状腺毒症患者，且均未接受任何抗甲状腺药物干预。其中，241例为Graves病（GD）患者，60例为自身免疫性甲状腺炎（AIT）患者。测定了STA-PSV、甲状腺功能及促甲状腺素受体抗体（TRAb）。采用多元线性回归分析确定与STA-PSV相关的因素。利用受试者工作特征（ROC）曲线及曲线下面积（AUC）评估STA-PSV对GD的鉴别能力。GD组的STA-PSV水平显著高于AIT组[61.00（41.00，86.50）cm/s对34.50（25.25，46.00）cm/s，P=0.001]。ROC曲线分析显示，AUC为0.790（95%CI：0.734-0.845），49.5cm/s为诊断GD的最佳截断点，此时敏感度为64.3%，特异度为83.3%。在所有甲状腺毒症患者中，多元线性回归分析显示游离甲状腺素（FT4）（β=0.371，95%CI：0.005-0.010，P=0.001）和TRAb（β=0.138，95%CI：0.001-0.014，P=0.035）与STA-PSV呈正相关。STA-PSV与FT4和TRAb水平呈正相关，是GD与AIT鉴别诊断中的一个有用指标。
