促甲状腺激素、甲状腺球蛋白抗体、过氧化物酶抗体对甲状腺疾病的诊断价值  

The serum TSH,TgAb,TpoAb value to the diagnosis of thyroid diseases

作　　者：黄静[1] 张文静[1] 吴靖芳[1] 刘亚超[2] 张耕[1] 薛刚[2] 

机构地区：[1]河北北方学院组胚教研室,河北张家口075000 [2]河北北方学院附属第一医院耳鼻咽喉头颈外科,河北张家口075000

出　　处：《重庆医学》2013年第32期3875-3877,3880,共4页Chongqing medicine

基　　金：河北省科技厅资助项目(12276104D-91);张家口市科技局资助项目(11110014D)

摘　　要：目的探讨不同甲状腺疾病患者血清中促甲状腺激素(TSH)、甲状腺球蛋白抗体(TgAb)、过氧化物酶抗体(TpoAb)的水平变化及其与甲状腺疾病的关系。方法收集383例甲状腺疾病病例资料,分为单纯甲状腺腺瘤(TA)组30例,单纯结节性甲状腺肿(NG)组59例,甲状腺乳头状增生(PTH)组36例,结节性甲状腺肿伴腺瘤(NG+TA)组196例,桥本甲状腺炎(HT)组13例,甲状腺癌(TC)组49例。分析6组患者血清中游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、TSH、TgAb、TpoAb与甲状腺疾病的相关性。结果 (1)TSH平均水平在HT组均值高于正常值上限,与TA组、NG组、PTH组、TA+NG组比较差异有统计学意义(P<0.05);TC组虽较高,但在正常范围波动,与各组比较差异无统计学意义。(2)TSH异常率、TgAb阳性率和TpoAb阳性率在HT组和TC组明显高于甲状腺良性肿瘤(BT)组(P<0.05)。(3)HT组和TC组甲状腺抗体双阳性率和TpoAb阳性率,均高于BT组(P<0.05)。结论血清TSH、TgAb、TpoAb水平与甲状腺疾病,尤其是与HT和TC有密切联系,TSH升高和TpoAb阳性在TC诊断中具有重要的参考价值。Objective To investigate the serum levels of Thyroid stimulating hormone（TSH）,Thyroglobulin antibody（TgAb） and Peroxidase antibodies（TpoAb） in patients with different thyroid diseases and to explore the relationship between the 3 indexes with thyroid diseases. Methods 383 cases of thyroid diseases were divided into six groups,simple adenoma of throid group（TA, n= 30）, nodular goiter group（NG, n ~ 59）, papillary thyroid hyperplasia group（PTH, n = 36）, nodular goiter with adenoma group （ NG ＋ TA, n ~ 196）, hashimoto＇ s thyroiditis （ HT, n = 13）, throid carcinoma group （TC, n = 49）. The relationship between concentra- tion of FT3, FT4, TSH,TgAb, TpoAb in serum and thyroid diseases incidence was analyzed. Results （1） The serum TSH concen- tration had statistically sinificance between group HT with group TA and NG,group PTH and TA＋NG group（P^0. 05）. Despite the concentration of serum TSH in TC group was in a high level near to the upper limit,there was no statistically significance ver- sus other groups. （2）In group HT and TC,the increased rate of TSH and positive rate of TgAb and TpoAb were significantly high- er than in group BT（P^0.05）. （3）The double positive rate of TgAb and TpoAb,the single positive rate of TpoAb in group HT and TC were higher than those in group BT（P^0.05）. Conclusion There was a close correlation between serum TSH,TgAb, TpoAb concentration and thyroid disease,especially closely associated with HT and TC. Raised TSH and TpoAb positive have im- portant reference value in diagnosis of TC.

关 键 词：甲状腺激素类 促甲状腺素 甲状腺肿瘤 甲状腺球蛋白抗体 过氧化物酶抗体 甲状腺良性肿瘤 

分 类 号：R446.6[医药卫生—诊断学]