摘要
目的:探讨TGA、TPO-Ab、TRAb和TSH在自身免疫性甲状腺病中的诊断和鉴别诊断价值。方法:采用化学发光法检测80例自身免疫性甲状腺病患者(桥本甲状腺炎40例,Graves病40例)、50例甲状腺结节患者和40例正常对照者血清TGA、TPO-Ab、TRAb和TSH水平,通过ROC曲线评估最佳诊断阈值。结果:自身免疫性甲状腺病(桥本甲状腺炎和Graves病)患者与非自身免疫性甲状腺疾病(甲状腺结节)患者血清TGA、TPO-Ab的差异有统计学差异(P<0.01),非自身免疫性甲状腺病患者组与正常对照组比较无统计学意义(P>0.05)。在自身免疫性甲状腺病患者中,Graves病患者TRAb水平高于桥本甲状腺炎患者(P<0.01),而TSH水平低于桥本甲状腺炎患者(P<0.01)。通过ROC曲线分析,当TGA、TPO-Ab分别为70.2U/ml、105.65IU/ml时,对自身免疫性甲状腺病的诊断具有最高的灵敏度和特异性;当TRAb、TSH分别为2.25IU/ml、0.60μlU/ml时,对Graves病和桥本甲状腺炎的鉴别诊断价值最高。实验室建立的参考值与试剂盒提供的参考值比较,具有更高的特异性。结论:TGA和TPO-Ab对自身免疫性甲状腺病的诊断具有重要意义,而TRAb和TSH对鉴别诊断Graves病和桥本甲状腺炎具有重要的临床应用价值。每个实验室有必要建立自己的参考范围,为临床和病人提供更准确、有效的信息。
Objective To evaluate diagnostic and differential diagnostic values of TGA,TPO-Ab,TRAb and TSH in autoimmune thyroid disease.Methods Serum TGA,TPO-Ab,TRAb and TSH were determined by chemiluminescence immunoassay in 80 patients with autoimmune thyroid disease（40 Hashimoto’s thyroditis and 40 Graves’ Disease）,50 patients with thyroid nodules and 40 normal controls respectively.Optimal diagnostic cut-off value of these assays were evaluated by ROC analysis.Results Test values of TGA and TPO-Ab showed statistical difference between autoimmune thyroid disease and non-autoimmune thyroid disease（P〈0.01）,but no difference between non-immune thyroid disease and healthy controls.Patients with Graves’ disease manifested higher TRAb but lower TSH values compared with patients with Hashimoto’s thyroditis（P〈0.01）.ROC analysis showed that TGA and TPO-Ab achieved optimal sensitivity and specificity for diagnosis of autoimmune thyroid disease with cut-off values as 70.2 U/ml and 105.65μIU/ml respectively.Meanwhile,Graves’ disease and Hashimoto’s thyroditis could be best differentiated when cut-off values as 2.25IU/ml and 0.60μIU/ml were used for TRAb and TSH respectively.Laboratory-based reference range showed higher specificity than that provided by assay supplier.Conclusion TGA and TPO-Ab may play vital role in the diagnosis of autoimmune thyroid disease,while TRAb and TSH had important clinical application values in differential diagnosis between Graves’ disease and Hashimoto’s thyroditis.It is necessary for laboratories to set up their own reference ranges,so that to provide more accurate and effective information for patients.
出处
《放射免疫学杂志》
CAS
2012年第5期541-544,共4页
Journal of Radioimmanology
