水源性高碘地区健康人群甲状腺自身抗体阳性筛查分析  

Screening analysis of positive thyroid autoantibody in waterborne high iodine area healthy people

作　　者：侯振江[1] 张靖宇[2] 牟兆新[1] 范洪[2] 王华新[3] HOU Zhen-Jiang ZHANG Jing-Yu MU Zhao-Xin FAN Hong WANG Hua-Xin(Institute of Thyroid Diseases, Cang- zhou Medical College, Cangzhou 061001, China)

机构地区：[1]沧州医学高等专科学校甲状腺疾病研究所,沧州061001 [2]河北省沧州中西医结合医院实验诊断科,沧州061001 [3]河北省黄骅开发区博爱医院,黄骅061100

出　　处：《中国免疫学杂志》2017年第3期401-406,共6页Chinese Journal of Immunology

基　　金：沧州医学高等专科学校甲状腺疾病临床研究创新团队和甲状腺疾病研究所自然科学课题(No.14Z001);河北省科技计划基金项目(No.15277796D)

摘　　要：目的:探讨沧州市健康体检人群甲状腺自身抗体的阳性率及其与甲状腺功能异常的相关性。方法:采用电化学发光免疫分析技术测定沧州市3 218名健康体检人群血清促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、甲状腺过氧化物酶抗体(TPOAb)和甲状腺球蛋白抗体(Tg Ab),分别以TPOAb>34 U/ml和Tg Ab>115 U/ml为阳性,对检测结果进行统计分析。结果:健康人群甲状腺自身抗体的总阳性率为16.19%,且随年份增加呈明显的增高趋势,不同性别之间的阳性检出率有显著性差异(P<0.001),其中TPOAb、Tg Ab、TPOAb和Tg Ab同时阳性的检出率分别为14.57%、12.74%和11.12%,1 686名女性的阳性检出率(21.53%、19.16%、16.67%)显著高于男性(6.92%、5.68%、5.03%),差异有统计学意义(P均<0.001),且随年龄增加阳性检出率逐渐升高,女性阳性率高峰在≥70岁年龄组,男性阳性率高峰在50~59岁年龄组。甲亢和亚甲亢、甲减和亚甲减甲状腺自身抗体的阳性检出率和OR均有显著性差异(P<0.001)。结论:沧州市健康体检人群甲状腺自身抗体的阳性率较高,对甲状腺功能正常而自身抗体阳性者进行动态监测、随访或早期干预,有利于甲状腺疾病的早期诊断、鉴别诊断及其防治。Objective： To investigate the correlation between positive rate of thyroid autoantibodies in healthy people and thyroid dysfunction. Methods： Fasting blood from 3 218 healthy examined people in Cangzhou were collected and the serum was separated. Automatic electrochemiluminescence immunoassay systems and reagents were used to determine the concentration of thyroid stimulating hormone（ TSH）,free triiodothyroninthyroid（ FT3）,free thyroxine（ FT4）,peroxidase antibody（ TPOAb） and thyroglobulin antibody（ Tg Ab）. TPOAb 〉 34 U/ml and Tg Ab 〉 115 U/ml was positives. Statistical analysis of test results. statistica analysis of test reults. Results： The positive rate of thyroid autoantibodies of tested population was 16. 19%. The positive rates of TPOAb and Tg Ab were 14. 57%,12. 74% separately. The detection rate of TPOAb and Tg Ab was 11. 12% in tested population. The positive rate of TPOAb and Tg Ab and TPOAb＋Tg Ab were 6. 92%,5. 68%,5. 03% separately in 1 532 male subjects and were 21. 53%,19. 16,16. 67%separately in 1 686 female subjects,which were significantly higher in female group than that in male group（ P〈0. 001）. They gradually increased with age and reached a peak above 70 years old in female group and in 50-59 in male group. The positive rate and OR of thyroid autoantibodies in hyperthyroidism and subclinical hyperthyroidism and in hypothyroidism and subclinical hypothyroidism and in hypothyroidism and subclinical hypothyroidism were statistically significant. Conclusion： The positive incidence of thyroid autoantibodies is higher in healthy people of Cangzhou. It is essential to follow-up these people of normal thyroid function with positive autoantibodies in order to facilitate prevention and early diagnosis and treatment of thyroid disease.

关 键 词：健康人群 甲状腺过氧化物酶抗体 甲状腺球蛋白抗体 电化学发光免疫分析法 

分 类 号：R581[医药卫生—内分泌] R446.62[医药卫生—内科学]