D'Azzò G, Pinzello G B, Pace F, Garofalo P, Craxì A, Jannì A
J Endocrinol Invest. 1985 Aug;8(4):331-6. doi: 10.1007/BF03348508.
The prognostic value of thyroid function parameters (T3, T4, rT3 and the rT3:T3 ratio) and common liver tests (serum bilirubin, albumin and prothrombin activity) was investigated on hospital admission in 100 consecutive patients with predominantly non-alcoholic liver cirrhosis. Twenty-nine out of 100 patients had a well compensated cirrhosis and their mean values of thyroid tests were similar to those of 40 healthy controls. A low T3 syndrome was found in the remaining 71 decompensated patients. In these thyroid function parameters were correlated with serum bilirubin and prothrombin activity. Moreover mean values of all thyroid and liver tests, except serum albumin, were significantly different between survivors and nonsurvivors at 3 months. To evaluate the best cut-off value which allowed to predict the outcome of patients, the Receiver Operating Characteristics (ROC) curves were generated for each test by plotting the values obtained in survivors at 3 months (true positives) vs nonsurvivors (false positives). By holding the false positive errors within 10%, the highest percentage of true positive results (i.e. patients dead at 3 months) was observed for the rT3:T3 ratio, rT3 and serum bilirubin at a cut-off point of 0.841, 55 ng/dl and 3.5 mg/dl, respectively. According to the above cut-offs the rT3:T3 ratio had the best positive predictive value (74%; 95% confidence limits 60-90%) in comparison to rT3 and bilirubin.
对100例以非酒精性肝硬化为主的连续入院患者进行了甲状腺功能参数（T3、T4、反三碘甲状腺原氨酸[rT3]及rT3:T3比值）和常见肝功能检查（血清胆红素、白蛋白及凝血酶原活性）的预后价值研究。100例患者中有29例肝硬化代偿良好，其甲状腺检查的平均值与40例健康对照者相似。其余71例失代偿患者存在低T3综合征。在这些患者中，甲状腺功能参数与血清胆红素及凝血酶原活性相关。此外，除血清白蛋白外，所有甲状腺和肝功能检查的平均值在3个月时存活者与非存活者之间存在显著差异。为评估能预测患者预后的最佳临界值，通过绘制3个月时存活者（真阳性）与非存活者（假阳性）获得的值，为每项检查生成了受试者工作特征（ROC）曲线。将假阳性误差控制在10%以内时，rT3:T3比值、rT3和血清胆红素在临界值分别为0.841、55 ng/dl和3.5 mg/dl时，观察到的真阳性结果百分比最高（即3个月时死亡的患者）。根据上述临界值，与rT3和胆红素相比，rT3:T3比值具有最佳的阳性预测值（74%；95%置信区间60 - 90%）。
