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Title: [Application of the superior thyroid artery peak systolic velocity in differentiating Graves' disease from autoimmune thyroiditis].
Author: Wang C, Zhu Y, Zhou LL, Zhao YY, Han XY, Ji LN.
Journal: Zhonghua Nei Ke Za Zhi; 2020 Mar 01; 59(3):207-212. PubMed ID: 32146747.
Abstract:
Objective: To evaluate the clinical value of the superior thyroid artery peak systolic velocity (STA-PSV) for the differential diagnosis of autoimmune thyrotoxicosis. Methods: 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. Results: 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, P<0.001]. The ROC curve analysis showed that the AUC was 0.790 (95%CI 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%CI 0.005-0.010, P<0.001) and TRAb (β=0.138, 95%CI 0.001-0.014, P=0.035) were positively associated with STA-PSV. Conclusions: 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. 目的： 探讨甲状腺上动脉峰值血流速度（STA-PSV）对自身免疫性甲状腺毒症病因鉴别诊断的临床应用价值。 方法： 收集2015年1月至2018年10月北京大学人民医院内分泌科新诊断的未用抗甲状腺药物治疗的自身免疫性甲状腺毒症患者301例，其中Grave病（GD）患者241例，自身免疫性甲状腺炎（AIT）患者60例，比较两组患者STA-PSV、甲状腺功能、促甲状腺激素受体抗体（TRAb）等相关指标。通过多元线性回归分析影响STA-PSV的相关因素。通过受试者工作特征（ROC）曲线下面积（AUC）评价STA-PSV对GD的鉴别能力。 结果： GD组STA-PSV明显高于AIT组[61.00（41.00，86.50）cm/s比34.50（25.25，46.00）cm/s，P<0.001]，ROC曲线分析，AUC为0.790（95%CI 0.734~0.845，P<0.001），当STA-PSV切点值≥49.5 cm/s时，诊断GD的敏感性为64.3%，特异性为83.3%。在所有甲状腺毒症患者中，以STA-PSV（对数转换后）为因变量，以游离甲状腺素（FT(4)）和TRAb为自变量进行多因素回归分析，结果显示STA-PSV与FT(4)（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）独立相关。 结论： STA-PSV对GD和AIT具有一定的鉴别诊断意义，且与甲状腺素水平和TRAb相关。.

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