血清TGAb、TPOAb联合检测对桥本甲状腺炎的诊断价值
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摘要
目的探讨血清抗甲状腺球蛋白抗体(TGAb)、抗甲状腺微粒体抗体(TPOAb)联合检测对桥本甲状腺炎的诊断价值。方法选取2016年5月~2017年12月在我院就诊的87例桥本甲状腺炎患者作为研究对象(A组),同时选取83例亚急性甲状腺炎患者(B组)和正常检查体检者(对照组)。采用化学发光法检测血清中TPOAb和TGAb水平,比较两者在各实验组间的水平差异,并且采用ROC曲线分析各指标对于桥本甲状腺炎的诊断价值。结果A组的TPOAb、TGAb水平明显高于B组和对照组(P<0.05)。TPOAb、TGAb在A组中的阳性率分别为88.51%、57.47%,与B组的79.12%和49.45%比较,差异无统计学意义(P>0.05)。ROC曲线分析显示,TGAb、TPOAb对于桥本甲状腺炎诊断的AUC面积分别为0.786和0.793,而采用联合检测的AUC面积为0.883,敏感度为88.4%,特异度为90.2%。结论 TGAb、TPOAb联合检测对桥本甲状腺炎可以做到有效的鉴别和诊断。
Objective To explore the diagnostic value of combined detection of serum TGAb and TPOAb in Hashimoto′s thyroiditis. Methods A total of 87 cases of Hashimoto′s thyroiditis in our hospital from May 2016 to December 2017 were selected as subjects(group A), and 83 patients with subacute thyroiditis(group B) and normal examination persons(the control group) were selected. The serum levels of TPOAb and TGAb were detected by chemiluminescence, the levels of thyroid autoantibodies in different groups were compared, and the diagnostic value of each index for Hashimoto′s thyroiditis was analyzed by ROC curve. Results The concentration of TPOAb and TGAb in group A were significantly higher than those in group B and the control group(P<0.05). The positive rates of TPOAb and TGAb in group A were 88.51% and 57.47% respectively, which were not significantly different with 79.12% and 49.45% in group B(P>0.05). ROC curve analysis showed that TGAb, TPOAb for Hashimoto′s thyroiditis diagnosis of AUC area was 0.786 and0.793, and the use of joint detection of AUC area was 0.883, sensitivity of 88.4%, specificity of 90.2%. Conclusion The combined detection of TGAb and TPOAb can effectively identify and diagnose Hashimoto′s thyroiditis.
Objective To explore the diagnostic value of combined detection of serum TGAb and TPOAb in Hashimoto′s thyroiditis. Methods A total of 87 cases of Hashimoto′s thyroiditis in our hospital from May 2016 to December 2017 were selected as subjects(group A), and 83 patients with subacute thyroiditis(group B) and normal examination persons(the control group) were selected. The serum levels of TPOAb and TGAb were detected by chemiluminescence, the levels of thyroid autoantibodies in different groups were compared, and the diagnostic value of each index for Hashimoto′s thyroiditis was analyzed by ROC curve. Results The concentration of TPOAb and TGAb in group A were significantly higher than those in group B and the control group(P<0.05). The positive rates of TPOAb and TGAb in group A were 88.51% and 57.47% respectively, which were not significantly different with 79.12% and 49.45% in group B(P>0.05). ROC curve analysis showed that TGAb, TPOAb for Hashimoto′s thyroiditis diagnosis of AUC area was 0.786 and0.793, and the use of joint detection of AUC area was 0.883, sensitivity of 88.4%, specificity of 90.2%. Conclusion The combined detection of TGAb and TPOAb can effectively identify and diagnose Hashimoto′s thyroiditis.
引文
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[10]赵树君,田恩江,孙富军,等.甲状腺过氧化物酶抗体在自身免疫性甲状腺疾病中的表现[J].中华内分泌代谢杂志,2007,23(3):251-252.
[11]毛敏静,叶廷军,彭奕冰,等.甲状腺球蛋白检测诊断分化型甲状腺癌的临床意义[J].检验医学,2016,31(3):185-188.
[12]朱梅,陶存武,许建宁,等.血清TGAb、TPOAb在甲状腺疾病中的应用价值[J].临床输血与检验,2012,12(2):135.
[13]冯刚,高忠,张雅娟.抗甲状腺过氧化物酶抗体(TPOAb)与疾病的关系[J].中国实验诊断学,2014,18(6):1044.
[14]方毅,龙亚红,左向华.ECLIA法检测血清促甲状腺激素受体抗体在自身免疫性甲状腺疾病中的诊断价值[J].中华临床医师杂志(电子版),2013,8(12):186-187.
[15]邓仁兵,王强,汪光蓉,等.ROC曲线评价促甲状腺激素受体抗体在Graves病中的诊断价值[J].现代检验医学杂志,2011,26(5):100-101.
[2]阮舒.甲状腺自身抗体在原发性甲状腺功能减退症诊断中的应用[J].齐齐哈尔医学院学报,2014,35(19):2866-2867.
[3]孙云霞.血清抗体检测在甲状腺疾病及其他疾病诊断中应用分析[J].临床研究,2016,24(3):202-203.
[4]郎江明.临床免疫诊断学[M].广州:广东科技出版社,2003:483.
[5]刘润幸.使用SPSS作多变量观测值的ROC曲线分析[J].中国公共卫生,2003,19(9):1151-1152.
[6]李跃松,朱亚妮,殷政芳,等.血清甲状腺过氧化物酶抗体在自身免疫性甲状腺疾病诊断中的应用[J].检验医学,2012,27(3):195-198.
[7]厉淑红,胡成进.血清TGAb、TPOAb检测在甲状腺疾病中的诊断意义[J].中国实验诊断学,2011,15(2):347-348.
[8]何珂,胡源,朱丽华,等.甲状腺功能亢进症患者中桥本甲状腺炎的比例及其生化和病理特征[J].中国全科医学,2017,20(2):214-218.
[9]吴定昌,黄超林,肖婷.血清TGAb、TPOAb检测在自身免疫性甲状腺疾病诊断中临床意义[J].检验医学与临床,2013,10(19):2530-2531.
[10]赵树君,田恩江,孙富军,等.甲状腺过氧化物酶抗体在自身免疫性甲状腺疾病中的表现[J].中华内分泌代谢杂志,2007,23(3):251-252.
[11]毛敏静,叶廷军,彭奕冰,等.甲状腺球蛋白检测诊断分化型甲状腺癌的临床意义[J].检验医学,2016,31(3):185-188.
[12]朱梅,陶存武,许建宁,等.血清TGAb、TPOAb在甲状腺疾病中的应用价值[J].临床输血与检验,2012,12(2):135.
[13]冯刚,高忠,张雅娟.抗甲状腺过氧化物酶抗体(TPOAb)与疾病的关系[J].中国实验诊断学,2014,18(6):1044.
[14]方毅,龙亚红,左向华.ECLIA法检测血清促甲状腺激素受体抗体在自身免疫性甲状腺疾病中的诊断价值[J].中华临床医师杂志(电子版),2013,8(12):186-187.
[15]邓仁兵,王强,汪光蓉,等.ROC曲线评价促甲状腺激素受体抗体在Graves病中的诊断价值[J].现代检验医学杂志,2011,26(5):100-101.