应用血液测定实验室诊断自身免疫性甲状腺疾病  

Laboratory diagnosis of autoimmune thyroid disease by blood testing

作　　者：杨晓岚 潘辉 范淑欢 

机构地区：[1]舟山市妇幼保健院检验科,浙江舟山316000

出　　处：《中国预防医学杂志》2011年第6期544-546,共3页Chinese Preventive Medicine

摘　　要：目的探讨甲状腺球蛋白抗体(TG-Ab)、甲状腺过氧化物酶抗体(TPO-Ab)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)对自身免疫性甲状腺疾病(AITD)的临床应用价值。方法采用化学发光免疫分析法定量检测153例自身免疫性甲状腺疾病患者、74例非自身免疫性甲状腺疾病患者和71例健康对照组血清中的TG-Ab、TPO-Ab、FT3、FT4。结果不同自身免疫性甲状腺疾病患者之间和自身免疫性甲状腺疾病患者与非自身免疫性甲状腺疾病患者及正常健康人群之间其TG-Ab、TPO-Ab、FT3、FT4水平差异有统计学意义。AITD组TG-Ab和TPO-Ab水平与非AITD组、健康对照组比较差异有统计学意义(P<0.01),桥本甲状腺炎组TG-Ab和TPO-Ab水平与Graves病组比较差异有统计学意义(P<0.01),桥本甲亢组和Graves病组FT3、FT4水平差异无统计学意义(P>0.05),而TPO-Ab、TG-Ab差异有统计学意义(P<0.01)。结论 TG-Ab、TPO-Ab、FT3、FT4四项指标对AITD的诊断及鉴别诊断有重要临床意义。Objective To explore the clinical value of blood testing for the diagnosis of autoimmune thyroid disease（AITD）.Methods We randomly selected 71 healthy controls,153 cases of AITD and 74 cases of non-AITD patients（simple goiter：56,thyroid adenoma：18） for the blood testing of thyroglobulin antibodies（TgAb）,thyroid peroxidase（TPO） antibodies（TPOAb）,FT3 and FT4 by ECLIA.Results There were no significant differences in the concentrations of TPOAb,TgAb,FT3 and FT4 between non-AITD patients and healthy controls.However,the concentrations of TPOAb and TgAb were significantly higher in the AITD patients of Hashimoto′s（HT）（765.9±363.9 and 546.8±208.5 IU/ml,respectively）,Graves′（GD）（183.6±109.2 and 54.0±44.8 IU/ml） and Hashitoxicosis diseases（678.1±316.9 and 525.1±205.9 IU/ml） than in controls（2.2±1.8 and 1.7±1.4 IU/ml）（P0.01）.The concentrations of FT3 and FT4 were also increased in the patients of GD（18.2±10.6 and 41.9±20.9 pmol/L,respectively） and Hashitoxicosis diseases（19.0±10.3 and 44.1±16.2 pmol/L）compared to that in controls（5.3±0.8 and 11.2±1.9 pmol/L）（P0.01）.There were no significant differences in the concentrations of FT3 and FT4 between the controls and HT patients.Conclusion The combination of TPOAb,TgAb,FT3 and FT4 testing can help the diagnosis of AITD and non-AITD patients.

关 键 词：自身免疫性甲状腺疾病 抗甲状腺过氧化物酶抗体 抗甲状腺球蛋白抗体 游离三碘甲状腺原氨酸 游离甲状腺素 

分 类 号：R581[医药卫生—内分泌]