异嗜性抗体对甲状腺功能测定干扰作用的研究  

Heterophile antibody interference in thyroid function assay

作　　者：伊然[1] 刘晓民[1] 詹晓蓉[1] 

机构地区：[1]哈尔滨医科大学附属第一医院内分泌科,150001

出　　处：《国际免疫学杂志》2011年第4期304-306,310,共4页International Journal of Immunology

基　　金：黑龙江省卫生厅科研课题（2009-059）,哈尔滨医科大学附属第一医院基金（2007094）

摘　　要：目的研究异嗜性抗体（HAb）对甲状腺功能测定的干扰，分析其临床特点并探讨减少和排除干扰作用的方法。方法2008年5月-2009年6月，在我院选择296例甲状腺功能测定表现为血浆TSH水平不适当增高的患者（FT3、FT4测定采用固相放射免疫分析方法，TSH测定采用免疫放射分析方法．IRMA），其中9例疑诊HAb增多症。对同份血清样本采用放射免疫分析方法（RIA）重新测定TSH，经速率散射比浊法除外血清类风湿因子（RF）干扰的可能性后，采用非免疫动物混合血清中和法对疑诊HAb增多患者的同份血清检测HAb。结果①9例疑诊HAb增多症的患者RIA法测定的TSH水平低于血清中和前IRMA法（P〈0．05），在其余287例TSH不适当增高患者RIA法测定的TSH水与血清中和前IRMA法组间比较，差异无统计学意义（P〉0．05）。②经非免疫动物血清中和后，上述9例疑诊HAb增多症的患者IRMA法的TSH测定结果明显低于血清中和前（P〈0．05），287例TSH不适当增高患者IRMA法的TSH测定结果与血清中和前比较，差异无统计学意义（P〉0．05）。③9例疑诊HAb增多症的患者非免疫动物血清中和前、后RIA法测定FT3和FT4组间比较，差异均无统计学意义（P均〉0．05）。④287例TSH不适当增高患者非免疫动物血清中和前、后RIA法测定FT3和FT4组间比较，差异均无统计学意义（P均〉0．05）。结论HAb增多可以明显干扰诸如IRMA法进行的非竞争性的双位点免疫分析，造成检测结果假性增高，而竞争性的放免分析方法受HAb干扰作用小。非免疫动物血清中和法能够减少或排除HAb的干扰。Objectives To analyze heterophilic antibody （HAb） interference in thyroid function assay and investigate the methods of reducing or eliminating the interference. Methods 296 patients with inappropriately elevated thyrotropin levels were selected form May 2008 to June 2009. Serum FT3 ,FT4 were measured with solid-phase radioimmun assay and TSH with immunoradiometric assay （IRMA）, all the results had been verified by retesting. At the same time, radioimmune assay （RIA） was used to examine serum TSH level of the same samples. After interference probably from rheumatoid factor （RF） was excluded by ratenephelometry, 9 cases of the all patients were found with suspectably increased HAb, the concentrations of serum FT3 ,FT4 ,TSH were further assayed via adding non-immune animal sera from different species. Results （1）The concentrate of TSH with RIA was significantly lower than that with IRMA in the 9 increased heterophile antibody cases （ P 〈 0.05） ,but there was no obvious difference between the concentrate of TSH with RIA and concentrate of TSH with IRMA in the 287 rest patients with elevated TSH level（P 〉 0.05 ）. （2）In the 9 increased heterophile antibody cases after HAb was neutralized by non-immune animal sera, the level of TSH was remarkable reduced （ P 〈 0.05 ） , but there was no obvious difference between the concentrate of TSH with IRMA and concentrate of TSH with IRMA in the 287 rest patients after HAb was neutralized by non-immune animal sera （ P 〉0.05 ）. （3）The values of serum FT3, FT4with RIA and The values of serum FT3 with RIA after HAb was neutralized by non-immune animal sera were still kept in nearly constant levels in the 9 increased heterophile antibody cases （ P 〉 0.05 ）. （4）The values of serum FT3, FT4with RIA and The values of serum FT3 with RIA after HAb was neutralized by non-immune animal sera were still kept in nearly constant levels in the 287 rest patients （ P 〉 0. 05）. Conclusions Heterophile antibody can interfere in the

关 键 词：异嗜性抗体 放射免疫分析 

分 类 号：R5[医药卫生—内科学]