目的：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：回顾性研究，选取2023年1月至2024年12月于我院确诊为TAO的患者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Th1型细胞因子\〖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：两组患者一般资料具有可比性。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，Ved、Vmax较对照组降低，RI、眼内直肌厚度均较对照组更高(均P<0.05)。Logistic回归分析显示，血清IFN-γ浓度、Ved、Vmax、眼内直肌厚度均是影响TAO发生的风险因素，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、0.642，IFN-γ、Ved、Vmax、眼内直肌厚度联合检测的AUC为0.840，约登指数为0.59，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，IFN-γ、Ved、Vmax、眼内直肌厚度联合用于TAO诊断效果更佳，可为TAO的早期诊断提供一定参考依据。

METHODS: A retrospective study was conducted on 45 patients diagnosed with TAO in our hospital from January 2023 to December 2024, and 20 normal volunteers during the same period as controls. Venous blood samples of the patients were collected to detect the concentrations of Th1-type cytokines \〖interferon-γ(IFN-γ), tumor necrosis factor-α(TNF-α), interleukin-2(IL-2), and interleukin-12(IL-12)\〗 in the serum. Additionally, the end diastolic velocity(Ved), velocity maximum(Vmax), resistance index(RI)of the central retinal artery, as well as the thickness and left-right diameter of the medial rectus muscle were measured. Logistic regression model was used to analyze the risk factors of TAO, and receiver operating characteristic curve(ROC)was adopted to evaluate the diagnostic efficacy of each index for the occurrence of TAO.

RESULTS: The general information of the two groups was comparable. Compared with the normal control group, the serum concentrations of IFN-γ and TNF-α in TAO patients were significantly increased, Ved and Vmax were lower than those in the control group, and RI and the thickness of the medial rectus muscle were higher than those in the control group(all P<0.05). Logistic regression analysis showed that serum IFN-γ concentration, Ved, Vmax, and the thickness of the medial rectus muscle were all risk factors for TAO. ROC curve analysis indicated that the AUCs of serum IFN-γ concentration, Ved, Vmax, and the thickness of the medial rectus muscle for the diagnostic efficacy of TAO were 0.756, 0.769, 0.732, and 0.642, respectively. The combined detection of IFN-γ, Ved, Vmax, and the thickness of the medial rectus muscle had an AUC of 0.840 and a Youden index of 0.59, which was superior to the detection of a single indicator.

CONCLUSION: The levels of serum Th1-type cytokines and extraocular muscle-related ultrasound indicators have certain value in the diagnosis of TAO. The combination of IFN-γ, Ved, Vmax, and the thickness of the medial rectus muscle has better diagnosis efficiency in TAO, which can provide a certain reference for the early diagnosis of TAO.