人血清TRAb酶联免疫吸附试验检测在甲状腺疾病患者中的临床应用  

The clinical application of human serum level of the TRAb measured by enzyme-linked immunosorbent assay in patients with thyroid diseases

作　　者：白庆双[1] 李宁[2] 方佩华[2] 吴彩兰[1] 葛建萍[1] 张伟[1] 

机构地区：[1]天津医科大学第四中心医院临床学院核医学科,300140 [2]天津医科大学总医院核医学科,300052

出　　处：《国际放射医学核医学杂志》2014年第2期80-83,共4页International Journal of Radiation Medicine and Nuclear Medicine

基　　金：天津市科技发展计划项目（05YFGDSF02700）

摘　　要：目的 探讨促甲状腺激素受体抗体（TRAb）水平对健康人和不同甲状腺疾病患者的临床意义.方法 分别以重组人促甲状腺激素受体（TSHR）膜外区氨基（N）端蛋白和羧基（C）端蛋白作为抗原建立N法和C法,分别检测89名健康者（正常对照组）和254例各种甲状腺疾病患者的血清TRAb水平,组间血清TRAb水平比较采用方差分析,组间阳性率比较采用x2检验.结果 应用N法检测发现：89名健康者405 nm处的光吸收值（（x）±s）为0.511±0.135,阳性切限值（（x）±2s）为0.789,阳性率为4.5％（4/89）;初发Graves病（毒性弥漫性甲状腺肿）患者及Hashimoto甲状腺炎伴甲状腺功能减退症（简称甲减）患者405 nm处的光吸收值（（x）±s）分别为：0.95±0.30、0.61±0.22,高于健康者（F=2.4851和2.0763,P均＜0.05）;N法对初发Graves病患者、治疗中的Graves 病患者、Graves病治疗恢复期患者、Hashimoto甲状腺炎伴甲减患者检测的阳性率分别为73.2％、55.9％、32.1％、45.0％,与正常对照组阳性率之间的差异均有统计学意义（x2=68.55、56.45、20.71和25.51,P均＜0.05）;初发Graves病患者阳性检出率高于Hashimoto甲状腺炎伴甲减患者（x2=4.63,P＜0.05）,初发Graves病患者与Graves病治疗恢复期患者阳性率之间的差异有统计学意义（x2=15.94,P＜0.05）.应用C法检测发现：89名健康者405 nm处的光吸收值（（x）±s）为0.507±0.142,阳性切限值（（x）＋2s）为0.791,阳性率为3.4％（3/89）;Hashimoto甲状腺炎伴甲减患者及初发Graves病患者405 nm处的光吸收值（（x）±s）为1.18±0.25、0.78±0.25,明显高于健康者（F=3.8164和2.4539,P＜0.05）;C法对Hashimoto甲状腺炎伴甲减患者、初发Graves病患者、治疗中的Graves病患者、Graves病治疗恢复期患者检测的阳性率分别为：75.0％、46.3％、23.6％、16.1％,与正常对照组阳性率之间的差异均有统计学意义（x2=66.34、36.87、15.79和7.3Objective To investigate the level of the thyrotropin recepter antibody （TRAb） in healthy people and patients with different types of thyroid disease,and discuss its clinical significance.Methods Recombinant human thyroid stimulating hormone receptor （TSHR）-ecd N-terminal fragment was used in N method and C-terminal fragment was used in C method as antigens respectively.The serum level of TRAb was measured in 89 healthy people and 254 patients with different types of thyroid disease respectively.The serum levels of TRAb comparison and positive rates comparison between groups were tested by analysis of variance and chi-square test respectively.Results The result of N method：the 405nm light absorption value （（x）±s） in healthy people was 0.511 ±0.135 with a cut-off value （（x）＋2s） of 0.789.The positive rate was 4.5％ （4/89）.The 405 nm light absorption value（（x）±s） in patients with incipient Graves （diffuse toxic goiter） and Hashimoto thyroiditis with hypothyroidism was 0.95±0.30,0.61±0.22 respectively,which was higher than that in healthy people （F=2.4851 and 2.0763,both P＜0.05）.The positive rate in incipient Graves disease,Graves disease with treatment,Graves disease patients in convalescence stage and Hashimoto thyroiditis with hypothyroidism was 73.2％,55.9％,32.1％,45.0％,respectively.There were significant differences between the above groups and the normal control group （x2=68.55,56.45,20.71 and 25.51,all P＜0.05）.The positive rate was significantly higher in incipient Graves disease patients than Hashimoto thyroiditis with hypothyroidism patients （x2=4.63,P＜0.05）.There was significant difference in the positive rate between incipient Graves disease and Graves disease patients in convalescence stage （x2=15.94,P＜0.05）.The result of C method：the 405 nm light absorption value （（x）±s） in healthy people was 0.507±0.142 with a cut-off value（（x）＋2s） of 0.791.The positive rate was 3.4％ （3/89）.The 405 nm light absorp

关 键 词：受体 促甲状腺素释放激素 酶联免疫吸附测定 甲状腺疾病 

分 类 号：R581[医药卫生—内分泌]