目的：本研究旨在探讨血清Th1型细胞因子水平与眼外肌相关指标在甲状腺相关眼病（TAO）诊断中的价值。?方法?：选取2023年1月至2024年12月于我院确诊为TAO患者45例，以及同期正常志愿者20例作对照。收集患者的静脉血样本，检测血清中干扰素-γ（IFN-γ）、肿瘤坏死因子-α（TNF-α）、白细胞介素-2（IL-2）与白细胞介素-12（IL-12）浓度，检测视网膜中央动脉舒张末期血流速度（Ved）、峰值流速（Vmax）与阻力指数（RI）、眼内直肌厚度和左右径。通过Logistic回归模型分析TAO危险因素，采用受试者工作特征曲线（ROC）评估各指标对TAO发生的诊断效能。?结果?：与正常对照组相比，TAO患者血清中IFN-γ和TNF-α浓度显著升高（P<0.05），Ved、Vmax较对照组降低，RI、眼内直肌厚度均较对照组更高。Logistic回归分析显示，血清IFN-γ浓度、Ved、Vmax、眼内直肌厚度均是诊断TAO的独立风险因素，ROC曲线分析提示血清IFN-γ浓度、Ved、Vmax、眼内直肌厚度对TAO诊断效能的AUC分别为0.756、0.769、0.732、0.692，而上述指标联合检测的AUC为0.840，约登指数为0.60，优于单一指标检测。?结论?：血清Th1型细胞因子水平与眼外肌相关超声指标在TAO诊断中具有一定价值，联合用于TAO诊断效果更佳，可为TAO的早期诊断提供一定参考依据。

objective: This research aimed to evaluate the diagnostic significance of serum Th1 cytokine levels and extraocular muscle-related parameters in thyroid-associated ocular disease (TAO). Methods: A total of 45 TAO patients diagnosed at our hospital between January 2023 and December 2024, along with 20 healthy volunteers as controls, were included. Serum concentrations of interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), interleukin-2 (IL-2), and interleukin-12 (IL-12) were measured from venous blood samples. Additionally, ocular artery blood flow velocity (EDV), resistance index (RI), and intraocular rectus muscle thickness were assessed using ultrasonography. Logistic regression analysis was conducted to identify independent risk factors for TAO, and receiver operating characteristic (ROC) curves were generated to evaluate the diagnostic performance of each parameter. ? Results: Compared to the control group, TAO patients exhibited significantly higher serum levels of IFN-γ and TNF-α (P<0.05), as well as increased peak systolic velocity (EDV), resistance index (RI), and thickness of the intraocular rectus muscles. Logistic regression revealed that serum IFN-γ and TNF-α concentrations, ocular artery RI, and intraocular rectus muscle thickness were independent risk factors for TAO diagnosis. ROC curve analysis showed that the area under the curve (AUC) values for these parameters were 0.756, 0.769, 0.732, and 0.692, respectively. When combining these indicators, the AUC increased to 0.840, with The Youden's Index of 0.60, outperforming individual parameter assessments.??Conclusion: Serum Th1 cytokine levels and extraocular muscle-related ultrasound parameters hold significant diagnostic value for TAO. Their combined use enhances diagnostic accuracy and provides valuable insights for early detection of TAO.

成都市医学科研项目(2024443)