目的 探讨甲状腺过氧化物酶抗体(TPOAb)测定在自身免疫性甲状腺疾病中的应用.方法 用电化学发光法测定130例Graves甲亢患者、117例桥本氏甲状腺炎患者、43例淋巴细胞性甲状腺炎患者、29例亚急性甲状腺炎患者、34例单纯性甲状腺肿患者、24例分化型甲状腺癌患者及63名对照者血清TPOAb的浓度,作出TPOAb诊断自身免疫性甲状腺疾病的受试者工作特征(ROC)曲线,并对各组TPOAb的浓度及阳性率进行比较.结果 ROC曲线下的面积为0.867,在cut-off值为33.51 IU/mL时,TPOAb诊断自身免疫性甲状腺疾病的敏感性为82％,特异性为89％；组间比较显示TPOAb浓度和阳性率在各组间差异有统计学意义(H=170.203,P＜0.05；x2=236.593,P＜0.05).两两比较显示自身免疫性甲状腺疾病各组与非自身免疫性甲状腺疾病各组间差异有统计学意义(P＜0.0024),而自身免疫性甲状腺疾病各组间差异无统计学意义(P ＞0.002 4).结论 TPOAb的测定在自身免疫性甲状腺疾病的诊断中具有重要临床意义.%Objective To investigate the clinical application of determining serum anti-thyroid peroxidase antibody ( TPOAb ) in patients with autoimmune thyroid diseases. Methods Serum TPOAb were measured by electrochemiluminescence immunoassay in 130 patients with Graves disease, 117 patients with Hashimoto's thyroiditis, 43 patients with lymphocytic thyroiditis, 29 patients with subacute thyroiditis, 34 patients with thyroid goiter, 24 patients with thyroid differentiated cancer and 63 controls. The receiver operating characteristic ( ROC) curve was calculated, and the concentrations of serum TPOAb and the positive rate were compared among the groups. Results The area under the ROC curve was 0. 867 ,the cut-off value was 33. 51 lU/mL, and the sensitivity and specificity were 82% and 89% at this cut-off value. The concentrations and positive rate of TPOAb had statistical significance among the groups ( H = 170. 203 ,P < 0. 05 ,x2 = 236. 593 ,P < 0. 05 ). The concentrations and positive rate of TPOAb had significant difference , between the group of autoimmune thyroid diseases and the group of non-autoimmune thyroid diseases (P < 0. 002 4 ). However, it had no significant difference between the groups of autoimmune thyroid diseases ( P > 0. 002 4). Conclusions The determination of serum TPOAb has an important value for the diagnosis of autoimmune thyroid diseases.
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