1585例正常人及不同甲状腺疾病患者血清TRAb水平的临床研究  

Clinical analysis of serum level of the TRAb in 1 585 normal people and patients with different thyroid diseases

作　　者：周静[1] 李宁[2] 方佩华[2] 冯凭[1] 

机构地区：[1]天津医科大学总医院代谢病科,300052 [2]天津医科大学总医院核医学科,300052

出　　处：《国际内分泌代谢杂志》2012年第3期151-154,共4页International Journal of Endocrinology and Metabolism

基　　金：天津市自然科学基金资助项目（033605811）

摘　　要：目的以制备的富含甲状腺刺激性抗体（TSAb）抗原决定簇的重组TrxTSHRn蛋白为抗原，建立酶联免疫吸附（ELISA）技术确定促甲状腺激素受体抗体（TRAb）的阳性剀限值，并初步应用于临床。方法以重组TrxTSHRn蛋白为抗原，通过不同的抗原包被量、不同的样品血清稀释度优化，建立间接ELISA检测方法（TRAb—NELISA以检测TSAb为主）。以此方法检测正常成人组1060例（年龄18～81岁），健康儿童27例及非自身免疫性疾病儿童（肺炎患儿）88例（年龄0—14岁，平均3．8岁），确定阳性切限值。检测不同甲状腺疾病患者血清TRAb水平。结果TRAb—NELISA检测正常成人组405nm处吸光度A405值（x±s）为0．398±0．167，儿童组为0．186±0．094，二者差异有统计学意义。亚组分析中，不同性别组之间及正常成人组各年龄段之间差异无统计学意义。成人组阳性切限值（x＋2s）为0．732，阳性率2．45％（26／1060）。初发Graves病患者阳性率70．31％（74／105）、治疗1年Graves病患者阳性率35．70％（10／28）、桥本甲状腺炎患者阳性率36．67％（44／120）、单纯甲状腺肿患者阳性率4．60％（2／43）、亚急性甲状腺炎患者阳性率6．67％（3／45）、非毒性结节性甲状腺肿患者阳性率7．25％（5／69）。结论儿童血清TSAb水平显著低于成人，而不同年龄、性别的成人之间TSAb水平无差异。初发Graves病患者TSAb阳性率较高，因此TSAb可用于Graves病的诊断、疗效观察及判断预后。Objective To establish enzyme linked immunosorbent assay（ELISA） using recombinent TrxTSHRn protein which contains thyroid stimulating antibody（TSAb） antigen determinant as antigen and the positive cutoff values of thyrotropin receptor antibody（TRAb） and then apply the assay in clinic. Methods U- sing recombinent TrxTSHRn protein as antigen, established the indirect ELISA for detecting the TRAb（ TRAb- N ELISA）by different amount of antigen and serum dilution optimization. This method was used to detect 1 060 cases of the normal adult group （aged 18 to 81 years old）, 27 cases of healthy children, 88 cases of non-auto- immune diseases children （children with pneumonia, age 0-14 years, mean 3.8 years） to determine the posi- tive cut off values. Detected TRAb in the serum of patients with different thyroid diseases. Results The A405 （x±s） of normal group was 0. 398 ± 0. 167 （in adult） and 0. 186 ± 0.094 （in children） by TRAb-N ELISA detecting, the difference had statistical significance. But there was no statistical significance in different age and gender in adults. The cutoff value （x ± 2s） in adult was 0. 732, and positive rate was 2.45% （ 26/1 060）. The positive rate in patients with newly-diagnosed Graves＇ disease was 70.31% （74/105） ,in patients with Graves＇ disease（treated for 1 year）was 35.70% （10/28）, in patients with Hashimoto＇s thyoiditis was 36.67% （44/ 120） ,in patients with simple goiter was 4.60% （ 2/43 ）, in patients with subacute thyroiditis was 6.67% （ 3/ 45） ,in patients with non-toxic nodular goiter was 7.25% （5/69）, respectively. Conclusions Serum level of TSAb in children is obviously lower than that in adults. But there are no differences between adults with differ- ent age or gender. The positive rate of TSAb in patients with newly-diaynosed Graves＇ disease is high, thus TSAb is valuable for the diagnosis ,evaluation of therapy and prognosis judgement of Graves＇ disease.

关 键 词：人促甲状腺激素受体 甲状腺刺激性抗体 酶联免疫吸附分析 自身免疫性甲状腺疾病 

分 类 号：R581[医药卫生—内分泌]