甲状腺摄碘率测定在亚急性甲状腺炎和甲状腺功能亢进症诊断与鉴别诊断

目的探讨甲状腺摄碘(131I)率测定在亚急性甲状腺炎(亚甲炎)和甲状腺功能亢进症(甲亢)诊断与鉴别诊断中的应用价值。方法 34例亚甲炎患者用化学发光免疫分析法(CLIA)测定血清游离三碘甲状腺原氨酸(FT3),血清游离甲状腺素(FT4),采用甲状腺功能仪进行甲状腺摄131I率测定,并与甲亢组患者和正常对照组进行对比分析。结果亚甲炎组患者血清FT3、FT4值均高于正常对照组,差异有统计学意义(P0.05),与甲亢组差异无统计学意义(P0.05);亚甲炎组患者2 h、6 h、24 h甲状腺摄131I率(RAIU)明显低于对照组和甲亢组,差异有统计学意义(P0.05),与血清FT3、FT4升高呈现"分离现象"。结论核医学检查的"分离现象"是早期诊断亚甲炎的灵敏度高、特异性强的方法。对初诊可疑的亚甲炎患者应首选甲状腺摄131I率测定,同时测定血清FT3、FT4,以免误诊、漏诊。

Application analysis of radioactive iodine uptake in helping for diagnosis and differential diagnosis of subacute thyroiditis and hyperthyroidism

Objective To evaluate the application value of radioactive iodine uptake(RAIU) in helping for diagnosis and differential diagnosis of subacute thyroiditis(SAT) and hyperthyroidism.Methods Serum FT3,FT4 were measured by chemiluminescent immunoassay(CLIA) in 34 patients with SAT,meanwhile RAIU was determined by thyroid function meter,compared with hyperthyroidism patients and normal subjects.Results The serum FT3,FT4 value of SAT was higher than that of control group,and there was significant difference(P<0.05).There was no significant difference as compared with the hyperthyroidism group(P>0.05).RAIU of 2 h,6 h,24 h in SAT group was significantly lower than that in normal control group and hyperthyroidism group,and there was significant difference(P<0.05).RAIU decreased and serum FT3,FT4 increase was "separating phenomenon".Conclusion Nuclear medicine inspection "separating phenomenon" is early diagnosis SAT of high sensitivity and specificity strong method.For suspicious beginning SAT patients,RAIU mensuration should be preferred,and simultaneous determination of serum FT3,FT4 should be performed to avoid misdiagnosis and missed diagnosis.