The Study On The Application Value Of FT4/FT3 Combined With NLR In The Etiological Identification Of Thyrotoxicosis

Objective To analyze the changes and significance of free thyroxine/free triiodothyronine(FT4/FT3),thyroid autoantibody titer,Ntrophil-to-Lymphocyte ratio(NLR),platelet-to-Lphocyte ratio(PLR),erythrocyte sedimentation rate(ESR),transaminase and Aumin(A)in patients with thyrotoxicosis caused by different etiologies,providing a new basis for the etiological differentiation of thyrotoxicosis.Methods Using a cross-sectional investigation,96 patients with thyrotoxicosis treated and newly diagnosed in the Department of Endocrinology in our hospital from January 2018 to January 2019 were analyzed retrospectively,including 29 patients with subacute thyroiditis(subacute thyroiditis group),48 patients with Graves’disease(Graves disease group),and 19 patients with Hashimoto’s thyroiditis or postpartum thyroiditis(Hashimoto’s thyroiditis or postpartum thyroiditis group).Thyroid hormone,autoantibody titer,complete blood count,transaminase and A were recorded.FT4/FT3,NLR and PLR were calculated.Results1.The numerical distribution levels of FT4/FT3,NLR and PLR in subacute thyroiditis group were higher than those in Graves disease group and Hashimoto’s thyroiditis or postpartum thyroiditis group.The numerical distribution level of Aumin in subacute thyroiditis group was lower than that of Graves disease group and Hashimoto’s thyroiditis or postpartum thyroiditis group.The numerical distribution levels of TRAb in Graves disease group were higher than that in subacute thyroiditis group and Hashimoto’s thyroiditis or postpartum thyroiditis group.2.Spearman rank sum analysis showed that:NLR was positively correlated with ESR(r=0.414,p<0.05),and PLR was positively correlated with ESR(r=0.369,p<0.05)in the patients with subacute thyroiditis.3.The analysis of receiver operating characteristic(ROC)curve showed that FT4/FT3 was the optimal diagnostic index of subacute thyroiditis,and NLR and PLR were also good diagnostic indexes.The cut-off values of FT4/FT3 and NLR in the diagnosis of subacute thyroiditis were 3.15[sensitivity,0.966,specificity,0.896,area under the ROC curve(AUC),0.968]and 1.92(sensitivity,0.931,specificity,0.896,AUC,0.962),respectively.The AUC of FT4/FT3 combined with NLR in the diagnosis of subacute thyroiditis was 0.994(sensitivity,0.931,specificity,1.000).Conclusion FT4/FT3 combined with NLR has certain clinical value in the differential diagnosis of subacute thyroiditis in thyrotoxicosis.