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目的:探讨未经治疗的甲状腺毒症患者甲状腺上动脉平均峰值流速(mean STA-PSV)与摄碘率的相关性,评价STA-PSV在甲状腺毒症病因鉴别中的价值。方法:本研究为前瞻性临床研究,共入选未经治疗的甲状腺毒症患者145例,包括Graves病组(n=96)和甲状腺炎组(n=49),在1周内测定其摄碘率、甲状腺功能与STA-PSV。采用两独立样本t检验比较Graves病组与甲状腺炎组患者摄碘率、甲状腺功能与STA-PSV的差异,用线性回归分析探讨3 h及24 h摄碘率与STA-PSV之间的相关性,用受试者工作曲线(ROC)评价STA-PSV对于Graves病和甲状腺炎的鉴别价值。结果:Graves病组的STA-PSV显著高于甲状腺炎组[(75.51±2.80)cm/s比(33.16±2.33)cm/s,P<0.05];平均STA-PSV与3 h摄碘率(r=0.532,P<0.001)以及24 h摄碘率(r=0.471,P<0.001)均呈显著正相关。平均STA-PSV鉴别Graves病与破坏性甲状腺炎的ROC曲线下面积为0.825,最佳切点为45.3 cm/s,敏感性为80.4%,特异性为81.4%。结论:平均STA-PSV与甲状腺摄碘率具有良好的相关性。结论:超声下甲状腺上动脉峰流速测定是一种可靠便捷的方法,可部分替代摄碘率用于甲状腺毒症的病因鉴别。
Objective: To investigate the relationship between mean STA-PSV and iodine uptake rate in untreated thyrotoxicosis patients and to evaluate the value of STA-PSV in the etiology of thyrotoxicosis. METHODS: This prospective, prospective clinical study included 145 untreated patients with thyrotoxicosis, including Graves disease (n = 96) and thyroiditis (n = 49), and their iodine uptake was determined within 1 week Rate, thyroid function and STA-PSV. The difference of iodine uptake rate, thyroid function and STA-PSV in patients with Graves disease and thyroiditis was compared by two independent samples t-test. The correlation between iodine uptake rate and STA-PSV at 3 h and 24 h was investigated by linear regression analysis The receiver operating characteristic curve (ROC) was used to evaluate the discriminatory value of STA-PSV for Graves’ disease and thyroiditis. Results: The STA-PSV in Graves’ disease group was significantly higher than that in thyroiditis group [(75.51 ± 2.80) cm / s vs (33.16 ± 2.33) cm / s, P <0.05] r = 0.532, P <0.001) and uptake of iodine 24 h (r = 0.471, P <0.001). The average area under the ROC curve of Graves’ disease and destructive thyroiditis with STA-PSV was 0.825, the best cut point was 45.3 cm / s, the sensitivity was 80.4% and the specificity was 81.4%. Conclusion: The average STA-PSV and thyroid iodine uptake rate has a good correlation. Conclusion: The determination of the peak velocity of the thyroid artery by ultrasound is a reliable and convenient method, which can partially replace the iodine uptake rate for the identification of the etiology of thyrotoxicosis.