运用ROC曲线方法评价TRAb、TPO-Ab和TGA在Graves'病和HT鉴别诊断中的意义  

Using ROC Curve to Evaluate the Value of TRAb,TPO-Ab and TGA in Differential Diagnosis of Graves' Disease and Hashimoto's Throiditis

作　　者：朱利靖[1] 张晨鹏[1] 孙晓光[1] 黄钢[1] 

机构地区：[1]上海交通大学医学院附属仁济医院核医学科临床核医学研究所,200127

出　　处：《放射免疫学杂志》2011年第5期564-567,共4页Journal of Radioimmanology

基　　金：国家自然科学基金资助项目(No.81071180);上海市科委重点基金资助项目(10JC1410000)

摘　　要：目的:应用临床诊断性能(ROC)曲线方法评价TSH受体抗体(TRAb)、甲状腺过氧化物酶抗体(TPO-Ab)和甲状腺球蛋白抗体(TGA)在Graves'病(格雷夫斯病)和桥本甲状腺炎鉴别诊断中的意义。方法:以甲状腺细针穿刺细胞学检查结果作为诊断金标准,以采用化学发光法测定63例自身免疫性甲状腺病患者血清的TRAb、TPO-Ab和TGA,通过临床诊断性能(ROC曲线)评价TRAb、TPO-Ab和TGA在Graves'病和桥本甲状腺炎(HT)在鉴别诊断中的应用价值。结果:通过ROC曲线评价TRAb、TPO-Ab和TGA,其ROC曲线下面积(AUC%)分别为79.2%8、1.9%8、7.2%,界值分别为13.80IU/ml1、81.00IU/ml4、0.50IU/ml。TRAb和TPO-Ab两项指标的联合应用的序列试验诊断效率最好,其值为88.9%。结论:TRAb和TPO-Ab两项指标联合应用的序列试验可很好地提高诊断的敏感度,对Graves'病和HT的鉴别诊断有一定的诊断价值,对治疗和预后判断提供一定的参考指标。Objective Using ROC curve to evaluate the value of TSH receptor antibody（TRAb）,thyroid peroxidase antibodies（TPO-Ab） and thyroid globulin antibody（TGA） in differential diagnose of Graves＇ disease and Hashimoto＇s thyroiditis.Methods Use thyroid fine needle aspiration biopsy as the gold standard and chemiluminescence method applied to detect the serum levels of TRAb,TPO-Ab and TGA in 63 patients suffering from AITD.Using ROC curve to evaluate the value of TSH receptor antibody（TRAb）,thyroid peroxidase antibodies（TPO-Ab） and thyroid globulin antibody（TGA） in differential diagnose of Graves＇ disease and Hashimoto＇s thyroiditis.Results The evaluation of TRAb,TGA and TPO-Ab through the ROC curves shows the ROC curves under area（AUC%） were 79.2%,81.9% and 87.2% separately.Critical value revealed is 181.00 IU/L,13.80 IU/ml and 40.50 IU/ml respectively.The best effect comes from the sequence test using combined application of TRAb and TPO-Ab,which has the maximum value of diagnostic efficiency 88.9%.Conclusion The sequence test using combined application of TRAb and TPO-Ab is very helpful for improving the sensitivity of the diagnosis.So it may serve as an indicator in differential diagnosis,treatment and prognostic evaluation of Graves＇ disease and Hashimoto＇s thyroiditis（HT）.

关 键 词：促甲状腺受体抗体 甲状腺过氧化物酶抗体 甲状腺球蛋白抗体 自身免疫性甲状腺病 Graves'病 桥本甲状腺炎 ROC曲线 

分 类 号：R195[医药卫生—卫生统计学]