血清TSH及TPOAb、TgAb水平在桥本氏甲状腺炎中的表达及临床意义分析  

Expression and clinical significance of serum TSH,TPOAb and TgAb in Hashimoto’s thyroiditis

作　　者：王明星 臧炫月 Wang Mingxing;Zang Xuanyue(Department of Laboratory Medicine,Huai’an First Hospital Affiliated to Nanjing Medical University,Huai’an 223003,China)

机构地区：[1]南京医科大学附属淮安第一医院检验科,淮安223003

出　　处：《中华内分泌外科杂志》2023年第6期729-733,共5页Chinese Journal of Endocrine Surgery

基　　金：江苏省自然科学基金(BK20190985)。

摘　　要：目的探讨血清促甲状腺激素(thyroid stimulating hormone,TSH)、甲状腺球蛋白抗体(thyroglobulin antibody,TgAb)、甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)在桥本氏甲状腺炎(Hashimoto’s thyroiditis,HT)中的诊断价值。方法在淮安市第一人民医院2019年10月至2022年10月收治的甲状腺疾病患者中选取90例,包括HT 30例(A组)、毒性弥漫性甲状腺病30例(B组)、甲状腺功能减退症30例(C组),另选取体检健康人30例作为对照组,对比所有患者的临床资料及血清指标水平。结果4组年龄、性别、体重指数(body mass index,BMI)、家族史、吸烟史、饮酒史差异无统计学意义(χ^(2)=0.327、1.358、0.231、1.617、0.592、0.889,P=0.806、0.716、0.875、0.655、0.898、0.828)。4组TSH水平分别为(7.25±1.36)、(1.31±0.25)、(6.58±1.16)、(2.28±0.75)mIU/L;4组TgAb水平分别为(46.25±5.24)、(45.15±5.36)、(43.15±5.06)、(25.25±2.16)IU/mL;4组TPOAb水平分别为(56.65±6.12)、(58.36±6.21)、(50.25±6.05)、(10.36±1.36)IU/mL;与对照组相比,A组、B组、C组TgAb、TPOAb水平均较高,A组、C组TSH水平较高,而B组TSH水平较低(F=287.96、135.59、537.05,P均<0.001)。经ROC分析显示,TSH、TgAb、TPOAb诊断HT的曲线下面积分别为0.732、0.779、0.883,且P<0.05;经一致性分析,A组与对照组经联合诊断阳性16例,灵敏度为46.67%,特异度为93.33%,准确率为70.00%,阳性预测值为87.50%,阴性预测值为63.64%,Kappa=0.55。结论HT患者的TSH、TgAb、TPOAb水平显著高于健康患者,能用于本病的诊断中且联合检测敏感度较高。Objective To explore the diagnostic value of serum thyroid stimulating hormone(TSH),thyroglobulin antibody(TgAb),and thyroid peroxidase antibody(TPOAb)in Hashimoto’s thyroiditis(HT).Methods 90 patients with thyroid diseases admitted to the First People’s Hospital of Huai’an City from Oct.2019 to Oct.2022 were selected,including 30 cases of HT(Group A),30 cases of toxic diffuse thyroid disease(Group B),and 30 cases of hypothyroidism(Group C).Another 30 healthy individuals who underwent physical examination were selected as the control group,and the clinical data and serum indicator levels of all patients were compared.Results Age,sex,body mass index;There was no significant difference in BMI,family history,smoking history or drinking history(χ^(2)=0.327,P=0.806;χ^(2)=1.358,P=0.716;χ^(2)=0.231,P=0.875;χ^(2)=1.617,P=0.655;χ^(2)=0.592,P=0.898;χ^(2)=0.889,P=0.828);Compared with the control group,TgAb and TPOAb levels in groups A,B and C were higher,TSH levels in groups A and C were higher,and TSH levels in group B were lower(F=287.96,P=0.000;F=135.59,P=0.000;F=537.05,P=0.000).According to ROC analysis,the area under the curve for diagnosing HT by TSH,TgAb,and TPOAb were 0.732,0.779,and 0.883,respectively,with P<0.05;After consistency analysis,there were 16 cases of positive diagnosis in Group A and the control group,with a sensitivity of 46.67%,a specificity of 93.33%,an accuracy of 70.00%,a positive predictive value of 87.50%,a negative predictive value of 63.64%,and Kappa=0.55.Conclusion The levels of TSH,TgAb,and TPOAb in HT patients are significantly higher than those in healthy patients,and can be used for the diagnosis of this disease with high sensitivity for combined detection.

关 键 词：桥本甲状腺炎 毒性弥漫性甲状腺病 甲状腺功能减退症 血清促甲状腺激素 

分 类 号：R581.4[医药卫生—内分泌]