血清TGAb、TPOAb检测在自身免疫性甲状腺疾病诊断中临床意义

摘要

目的探讨血清中抗甲状腺球蛋白抗体（TGAb）、抗甲状腺过氧化酶抗体（TPOAb）浓度在自身免疫性甲状腺疾病（AITDs）诊断中的临床意义。方法以 Graves 病（GD）120例、桥本甲状腺炎（HT ）130例、健康对照90例样本为试验材料，采用电化学发光免疫分析法测定血清中 TGAb 、TPOAb 浓度。结果 TGAb 、TPOAb 绝对含量和阳性率在各组间差异均有统计学意义（P ＜0．05），其中 HT 组最高。将血清 TGAb 、TPOAb 单项检测结果用于 Graves 病（GD）临床诊断时，ROC 曲线面积分别为0．866和0．990；用于桥本甲状腺炎（HT ）临床诊断时，ROC曲线面积分别为0．960和0．991；在 GD 组与 HT 组间比较时（GD 比 HT ），TGAb 、TPOAb 的 Youden 指数为0．333和0．549。结论血清中 TGAb 和 TPOAb 浓度测定均可用于 GD 和 HT 疾病的临床诊断，TPOAb 优于 TGAb ，但它们对区分 GD 与 HT 的临床诊断价值低。%Objective To evaluate the diagnosis value of serum thyroglobulin antibody (TGAb) and thyroid peroxidase antibody (TPOAb) in autoimmune thyroid diseases (AITDs) .Methods Electrochemiluminescence assay was performed to detect serum TGAb and TPOAb in 120 patients with Graves′ disease (GD ,GD group) ,130 patients with Hashimoto′s thyroiditis (HT ,HT group) ,and 90 healthy subjects (control group) .Results The absolute con-centrations and positive rates of serum TGAb and TPOAb were significantly different among the three groups (P<0 .05) ,with the highest values observed in HT group .The areas under receiver operating characteristic curve of TGAb and TPOAb were 0 .866 and 0 .990 in the diagnosis of GD ,were 0 .960 and 0 .991 in the diagnosis of HD ,and comparison between GD and HT groups indicated that the Youden indexes of the serum TGAb and TPOAb were 0 .333 and 0 .549 ,respectively .Conclusion Detection of serum levels of TGAb and TPOAb could be used for the di-agnosis of GD and HT ,and the diagnostic value of TPOAb might be superior to TGAb ,but the value of differential diagnosis of GD and HT might be relatively low .