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新型炎症标志物与甲状腺相关性眼病活动性的相关性研究

Study on the correlation between novel inflammatory markers and the activity of thyroid-associated ophthalmopathy

    摘要
  • 摘要:
    目的  探讨新型炎症标志物单核细胞与高密度脂蛋白胆固醇比值（MHR）、全身免疫炎症指数（SII）与甲状腺相关性眼病（TAO）活动性的相关性。
    方法 回顾性分析2023年1月至2025年7月在华北理工大学附属医院内分泌与代谢病科住院治疗的84例TAO患者临床资料。根据临床活动性评分（CAS）分为活动性组（CAS≥3分）和非活动性组（CAS ＜ 3分），收集2组一般资料、血常规、血生化、甲状腺功能、眼眶核磁共振（MRI）检查参数等指标。采用相关性分析、Logistic回归及受试者操作特征（ROC）曲线评估各指标的诊断价值。
    结果 二元Logistic回归分析提示，MHR、SII、EMA是TAO活动性患者的独立影响因素（均P ＜ 0.05）。ROC曲线分析提示，MHR对应的曲线下面积（AUC）值为0.679，95% CI为55.8%～80.0%，P = 0.006，最佳界值为0.320，灵敏度为0.868，特异度为0.452；SII相应的AUC值为0.652，95% CI为53.1%～77.4%，P = 0.020，最佳界值为0.298，灵敏度为0.717，特异度为0.581；联合诊断指标的AUC值为0.717，95% CI为60.8%～83.0%，P = 0.001，最佳界值为0.429，灵敏度为0.623，特异度为0.806。
    结论 联合诊断指标的特异度最高，AUC值也相对较高，表明其在诊断TAO患者活动性方面具有较好的平衡性和较高的准确性。MHR与SII作为易获取的血液炎症标志物，可成为TAO活动性影像学评估的有效补充。MHR、SII及二者联合诊断指标可能成为评估TAO患者活动性的有价值指标。

     

    Abstract:
    Objective To investigate the correlation between the novel inflammatory markers monocyte to high density lipoprotein cholesterol ratio (MHR), systemic immune inflammation index (SII) and the activity of thyroid associated ophthalmopathy (TAO).
    Methods The clinical data of 84 patients with TAO who were hospitalized in the Department of Endocrinology and Metabolic Diseases, the Affiliated Hospital of North China University of Science and Technology, from January 2023 to July 2025 were retrospectively analyzed. According to the clinical activity score (CAS), the patients were divided into the active group (CAS ≥ 3 points) and the inactive group (CAS ＜ 3 points). General data, routine blood test results, blood biochemical indicators, thyroid function, orbital magnetic resonance imaging (MRI) parameters, and other indicators were collected from the two groups. Correlation analysis, Logistic regression and receiver operating characteristic (ROC) curve analysis were used to evaluate the diagnostic value of each indicator.
    Results  Binary Logistic regression analysis showed that MHR, SII and EMA were independent influencing factors for TAO activity (P ＜ 0.05). ROC curve analysis showed that the area under the curve (AUC) for MHR was 0.679, with a 95% CI of 55.8%-80.0% and P = 0.006. The optimal cut off value was 0.320, with a sensitivity of 0.868 and a specificity of 0.452. The AUC for SII was 0.652, with a 95% CI of 53.1%-77.4% and P = 0.020. The optimal cut off value was 0.298, with a sensitivity of 0.717 and a specificity of 0.581. The AUC for the combined diagnostic indicator was 0.717, with a 95% CI of 60.8%-83.0% and P = 0.001. The optimal cut-off value was 0.429, with a sensitivity of 0.623 and a specificity of 0.806.
    Conclusions  The combined diagnostic indicator had the highest specificity and a relatively high AUC, indicating that it has good balance and high accuracy in diagnosing activity in patients with TAO. As readily available blood inflammatory markers, MHR and SII may serve as effective supplements to imaging assessment and are correlated with TAO activity. MHR, SII and their combined diagnostic indicator may become valuable indicators for assessing activity in patients with TAO.

     

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