自身免疫性甲状腺疾病诊疗中3种自身抗体的临床价值

目的 :为研究 3种甲状腺自身抗体 ,即 TSH受体抗体 (TRAb)、甲状腺球蛋白抗体 (Tg Ab)、甲状腺微粒体抗体 (Tm Ab)在自身免疫性甲状腺疾病 (AITD)的病因和鉴别诊断、疗效监测及预测复发等方面的价值。方法 :采用放射受体分析法和放射免疫分析法对首次确诊的 AITD甲亢组、AITD甲减组、非 AITD组以及对照组血清 TRAb、Tg Ab、Tm Ab进行检测。结果 :血清 TRAb、Tg Ab、Tm Ab阳性率分别为 89.7%、37.9%、4 6 .6 % ;2 9.0 %、83.9%、90 .3% ;0 .0 %、15 .8%、10 .5 % ;0 .0 %、3.3%、0 .0 %。结果显示 AITD甲亢组中 TRAb显著高于其他 3组 (P<0 .0 1) ,且与其血清 FT3、FT4 明显正相关 ;而 AITD甲减组 Tg Ab和 Tm Ab则明显高于其余 3组 (P<0 .0 1) ;在非 AITD组中这 3种抗体均无明显异常。结论 :甲状腺自身抗体的测定对 AITD的诊断与鉴别诊断、疗效监测及预测复发等具有重要的临床价值

The clinical value of autoantibodies in diagnosis and treatment of autoimmune thyroid diseases

Objective:To explore the clinical value of three sorts of thyroid autoantibodies-TSH-receptor antibody (TRAb), thyroglobulin antibody (TgAb), thyroid microsome antibody (TmAb) in pathogenetic and differential diagnosis, monitor of curative effect and relapse of autoimmune thyroid diseases (AITD). Methods:The serum concentrations of TRAb were investigated by radioreceptor assay and the binding rates of TgAb and TmAb were investigated by radioimmunoassay in patients with non-treat AITD hyperthyroidism, AITD hypothyroidism, non-AITD hyperthyroidism and normal control.Results:The positive rates of serum TRAb, TgAb and TmAb in each group were 89.7%, 37.9%, 46.6%; 29.0%, 83.9%, 90.3%; 0.0%, 15.8%, 10.5%; 0.0%, 3.3%,0.0% respectively.The expressions of TRAb in non- treat AITD hyperthyroidism group were significantly higher than those in AITD hypothyroidism group, non-AITD hyperthyroidism group and normal control (P<0.01), and were positively related to their serum average levels of FT 3 and FT 4. The positive rates of serum TgAb, TmAb in AITD hypothyroidism group were apparently higher than those in others group (P<0.01). But three sorts of autoantibodies were not obviously abnormal in non-AITD hyperthyroidism group.Conclusions:The data suggest that detection of thyroid autoantibodies be very useful for pathogenetic and differential diagnosis, monitor of curative effect and relapse of autoimmune thyroid diseases.