血清 TPO-Ab、TSH 、TGA检测在孕妇甲状腺疾病筛查中的意义

摘要

目的：探讨血清抗甲状腺过氧化物酶抗体（TPO‐Ab）、促甲状腺激素（TSH）、抗甲状腺球蛋白抗体（TGA）在孕妇甲状腺疾病筛查中的应用价值。方法选取该院2014年1月至2015年6月125例经颈部超声诊断为甲状腺结节增生的孕妇为甲状腺疾病组，另选取在该院行常规性产前检查且无甲状腺家族史或既往病史的120例孕妇为妊娠对照组，选取100例非妊娠育龄健康妇女为健康对照组，采用化学发光法测定各组血清TPO‐Ab、TSH、TGA水平及阳性率。采用受试者工作特征曲线（ROC曲线）分析TPO‐Ab、TSH、TGA在孕妇早期甲状腺疾病筛查中的应用价值。结果甲状腺疾病组患者血清中TPO‐Ab、TSH、TGA水平及阳性率显著高于妊娠对照组及健康对照组，差异有统计学意义（P＜0．05）。经ROC曲线分析可知，灵敏性由高到低依次为TPO‐Ab、TSH、TGA ；特异性由高到低依次为TPO‐Ab、TSH、TGA ；TPO‐Ab、TSH、TGA联合诊断时灵敏性及特异性高于单一指标诊断。结论 TPO‐Ab、TSH、TGA可作为孕妇甲状腺疾病的诊断指标，通过联合诊断的方法可提高其在临床上的应用价值。%Objective To investigate the application value of anti‐thyroid peroxidase antibodies(TPO‐Ab) ,thyroid stimulating hormone(TSH) ,anti‐thyroglobulin antibody(TGA) in screening thyroid disease among pregnant women .Methods A total of 125 pregnant women of thyroid nodule diagnosed by neck ultrasonography in our hospital from January 2014 to June 2015 were selected as the thyroid disease group ,other 120 pregnant women with no thyroid disease family history or past disease history by the routine antenatal examination were selected as the pregnant control group .And 100 non‐pregnant child‐bearing healthy women were select‐ed as the healthy control group .The levels of serum TPO‐Ab ,TSH and TGA ,and positive rate in each group were detected by u‐sing the chemiluminescence method .The receiver operation working(ROC) curve was adopted to evaluate the application value of TPO‐Ab ,TSH and TGA in screening early thyroid disease among pregnant women .Results The serum TPO‐Ab ,TSH and TGA levels and positive rate in the thyroid disease group were significantly higher than those in the pregnant control group and healthy control group(P<0 .05) ,the ROC curve analysis showed that the sensitivity from high to low were TPO‐Ab ,TSH and TGA ;the specificity from high to low were TPO‐Ab ,TSH ,TGA ;the sensitivity and specificity in TPO‐Ab ,TSH and TGA combined diagno‐sis were higher than those in single index diagnosis .Conclusion TPO‐Ab ,TSH and TGA can be used as diagnostic indicators for pregnant women thyroid disease ,the joint diagnosis method can increase their clinical application value .