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目的探讨测定亚临床甲减向临床甲减转化时血清TH、cTnI和BNP水平的临床价值。方法采用化学发光法免疫分析测定103例亚临床甲减组、45例临床甲减组和60例正常对照组,并进行对比性分析。利用ROC曲线评价血清FT3、FT4、TSH、cTnI和BNP水平预测临床甲减的价值。结果103例亚临床甲减组血清FT3、FT4水平较正常对照组差异无统计学意义(P>0.05),而血清TSH水平明显增高(P<0.01)。45例临床甲减组血清FT3、FT4、TSH水平较60例正常对照组分别为明显降低(P<0.01)、显著降低(P<0.001)和显著增高(P<0.001)。103例亚临床甲减血清cTnI水平增高(P<0.05),45例临床甲减患者为明显增高(P<0.01);103例亚临床甲减组血清BNP水平降低(P<0.05),45例临床甲减患者为明显降低(P<0.01)。ROC曲线辨别了血清TSH、cTnI和BNP的判定值水平分别为13.88mIU/L、0.57ng/ml和44.78pg/ml,对预测甲减均有较高的灵敏度和特异性,以血清TSH水平为最好。结论血清TSH水平测定是亚临床甲减向临床甲减转化时最有价值的指标。
Objective To investigate the clinical value of serum TH, cTnI and BNP levels in clinical hypothyroidism clinical hypothyroidism. Methods Chemiluminescence immunoassay was used to determine 103 subclinical hypothyroidism patients, 45 clinical hypothyroidism patients and 60 normal controls, and to conduct comparative analysis. ROC curve was used to evaluate the value of serum FT3, FT4, TSH, cTnI and BNP levels in predicting clinical hypothyroidism. Results The levels of serum FT3 and FT4 in subclinical hypothyroidism group were not significantly different from those in normal control group (P> 0.05), but serum TSH levels were significantly increased (P <0.01). The levels of serum FT3, FT4 and TSH in 45 hypothyroidism patients were significantly lower (P <0.001) and significantly higher (P <0.001) than the 60 normal controls (P <0.01). Clinical subclinical hypothyroidism serum cTnI levels were increased in 103 cases (P <0.05), 45 cases of clinical hypothyroidism were significantly increased (P <0.01); 103 cases of subclinical hypothyroidism serum BNP levels were decreased (P <0.05), 45 cases Clinical hypothyroidism was significantly reduced (P <0.01). The ROC curve discriminated the levels of serum TSH, cTnI and BNP were 13.88mIU / L, 0.57ng / ml and 44.78pg / ml respectively, which had high sensitivity and specificity for predicting hypothyroidism. Serum TSH levels were the best. Conclusion The serum TSH level is the most valuable index for clinical hypothyroidism in subclinical hypothyroidism.