桥本甲状腺炎伴甲状腺激素自身抗体的临诊应对  

Approach to the Hashimoto thyroiditis patient with thyroid hormone autoantibodies

作　　者：李玲 臧丽 吕朝晖 母义明 Li Ling;Zang Li;Lyu Zhaohui;Mu Yiming(Department of Endocrinology,The First Medical Center of Chinese PLA General Hospital,Beijing 100853,China;Department of Endocrinology,Shijingshan Teaching Hospital of Capital Medical University,Beijing Shijingshan Hospital,Beijing 100043,China)

机构地区：[1]中国人民解放军总医院第一医学中心内分泌科,北京100853 [2]首都医科大学石景山教学医院,北京市石景山医院内分泌科,100043

出　　处：《中华内分泌代谢杂志》2020年第5期421-424,共4页Chinese Journal of Endocrinology and Metabolism

摘　　要：回顾性分析1例以甲状腺功能异常为主诉的桥本甲状腺炎合并甲状腺素抗体(T4Ab)阳性患者的临床特征及诊治策略。该病例无特殊临床表现,多次查甲状腺激素水平示血清甲状腺素(TT4)和游离甲状腺素(FT4)轻中度升高、三碘甲状腺原氨酸(TT3)和游离三碘甲状腺原氨酸(FT3)正常,促甲状腺激素(TSH)多处于轻中度升高、偶有正常或轻度抑制状态,基于实验室检查与临床表现不符,考虑存在检测误差的可能性,通过比较不同方法检测结果和免疫沉淀法沉淀抗体后,采用放免法检测证实存在T4Ab。甲状腺激素自身抗体(THAAb)是一种相对少见的甲状腺自身抗体,常导致临床误诊误治,需引起临床医师的高度重视。To discuss the clinical features and treatment of a 27-year-old female patient with Hashimoto thyroiditis and thyroxine autoantibody(T4Ab)positive complained of abnormal thyroid function.The patient had no special clinical manifestations.Multiple measurements of thyroid function showed that surum FT4 and TT4 were elevated,while FT3 and TT3 remained normal,TSH was mainly elevated(occasionally normal or slight inhibited).We considered the possibility of the existence of laboratoury errors based on the inconsistency between the laboratory examination and clinical features,and the presence of T4Ab was effectively confirmed by radioimmunoassay after comparing the test results of different methods and immunoprecipitation method.THAAb is a relatively rare antibody,which often leads to clinical misdiagnosis or even mistreatment.Therefore,clinicians should pay great attention to it.

关 键 词：甲状腺激素自身抗体 桥本甲状腺炎 免疫沉淀法 化学发光微粒子免疫法 

分 类 号：R5[医药卫生—内科学]