TGAb、TPOAb检测在自身免疫性甲状腺疾病诊断中的意义

目的了解血清抗甲状腺球蛋白抗体（TGAb）和抗甲状腺过氧化物酶抗体（TPOAb）的测定对自身免疫性甲状腺疾病的临床诊断意义。方法用化学发光免疫分析法定量检测153例甲状腺疾病患者和75例健康对照者血清促甲状腺激素（TSH）、血清甲状腺素（T4）、游离甲状腺素（FT4）、三碘甲状腺源氨酸（T3）、游离三碘甲状腺原氨酸（FT3）TGAb、TPOAb含量,并做比较分析。结果不同甲状腺疾病患者和正常人群体内TGAb、TPOAb含量和阳性率差异有统计学意义。结论TGAb、TPOAb检测对甲状腺疾病的诊断尤其是自身免疫性疾病如桥本病和Graves病的诊断重要的临床意义。     

血清TGAb、TPOAb检测在甲状腺疾病中的诊断意义

甲状腺球蛋白抗体（TGAb）是主要的特异性甲状腺自身抗体,是甲状腺上皮细胞分泌的糖蛋白。甲状腺过氧化物酶抗体（TPOAb）是自身免疫性甲状腺疾病（antoimmune thyroid disease,AITD）的一种重要自身抗体,是慢性淋巴细胞性甲状腺炎的特异性诊断指标。     

甲状腺抗体与自身免疫性甲状腺疾病

本文对目前常用的测定甲状腺自身免疫性抗体的方法进行了综述，介绍了甲状腺球蛋白抗体甲状腺微粒体／过氧化物酶抗体和促甲状腺素受体抗体在自身免疫性甲状腺疾病的临床诊断和病程评估中的应用。     

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

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;χ2=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<0.002 4),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。     

血清甲状腺球蛋白抗体、甲状腺微粒体抗体、甲状腺过氧化物酶抗体对自身免疫性甲状腺疾病的诊断价值

目的探讨血清甲状腺球蛋白抗体（TGAb）、甲状腺微粒体抗体（TMAb）、甲状腺过氧化物酶抗体（TPOAb）对自身免疫性甲状腺疾病（AITD）的诊断价值。方法100例甲状腺功能异常患者根据血清中三碘甲状腺原氨酸（B）、甲状腺素（Td）、促甲状腺激素（TSH）水平分为甲亢组和甲减组,每组50例;另选择50例甲状腺功能正常人群作为对照组。各组患者均采集静脉血5mL,分离血清,放射免疫法测定患者血清中TGAb、TMAb、TPOAb、L、T4、TSH水平。观察各组患者血清中TGAb、TMAb、TPOAb阳性率;比较各组TGAb、TMAb、TPOAb阳性患者血清水平。结果甲亢组和甲减组血清TPOAb阳性率均明显高于血清TGAb、TMAb阳性率;甲亢组、甲减组患者血清TGAb、TMAb、TPOAb阳性率均明显高于对照组;甲减组患者血清TGAb、TMAb、TPOAb阳性率均明显高于甲亢组。甲亢组和甲减组患者血清TGAb、TMAb、TPOAb水平均明显高于对照组。甲减组患者血清中TGAb、TMAb、TPOAb水平均明显高于甲亢组。结论TPOAb在AITD的诊断中具有重要意义,为AITD的诊断、治疗及预后评估提供了重要依据。     

促甲状腺激素和甲状腺自身抗体在甲状腺疾病诊断中的临床应用

目的通过探讨自身免疫性甲状腺疾病(AITD)患者血清促甲状腺激素(TSH)、抗甲状腺过氧化物酶抗体(TPOAb)、抗甲状腺球蛋白抗体(TGAb)、促甲状腺激素受体抗体(TRAb)浓度的变化,探讨其在自身免疫性疾病的诊断价值。方法对30例毒性弥漫性甲状腺病(GD)、32例桥本甲状腺炎(HT)、24例甲状腺机能减退症患者和39例健康者采用化学发光法分别检测TSH、TPOAb、TGAb、TRAb,并观察这4种指标在不同疾病中的变化情况。结果甲状腺机能减退症组的TSH含量为(33.90±34.36)mIU/L,明显高于健康对照组,而GD组为(0.05±0.05)mIU/L,则明显低于健康对照组;GD组、HT组和甲状腺机能减退症组血清TPOAb、TGAb浓度明显高于健康对照组;GD组TRAb的含量为(11.34±12.07)IU/mL,显著高于其他3组,差异均有统计学意义(P<0.05)。结论 TSH是甲状腺功能的非常敏感的特异性指标,TPOAb、TGAb的检测对甲状腺疾病诊断有重要意义,而TRAb对于GD有较高的诊断价值,可以作为诊断GD病的特异性指标。     

TGAb联合TPOAb用于妊娠期自身免疫性甲状腺疾病筛查的临床价值

目的 探讨甲状腺球蛋白抗体(TGAb)联合甲状腺过氧化物酶抗体(TPOAb)用于妊娠期自身免疫性甲状腺疾病(AITDs)筛查的临床价值。方法 随机选取在该院进行孕检的妊娠妇女300例作为孕期组,其中包含孕早期、孕中期和孕晚期妇女各100例,另选取同期非妊娠期健康妇女100例作为对照组。检测研究对象血清促甲状腺激素(TSH)、游离甲状腺素(FT₄)、TGAb和TPOAb水平,比较两组甲状腺疾病发病率,绘制受试者工作特征曲线分析TGAb和TPOAb诊断AITDs的价值,采用直线回归分析TGAb和TPOAb的相关性。结果 孕期组的甲状腺疾病的总发病率(17.00%)高于对照组(13.00%),在所有研究对象中以亚临床甲状腺功能减退和单纯抗体阳性的发病率最高,分别为7.50%和3.50%。TGAb诊断AITDs的曲线下面积(AUC)为0.778,TPOAb诊断AITDs的AUC为0.895,二者联合检测的AUC为0.985。TGAb和TPOAb不具有线性相关性。结论 TGAb和TPOAb在AITDs的诊疗过程中不可相互替代,且通过联合检测可以提高其对于AITDs的诊断价值...     

甲状腺疾病患者两种血清甲状腺自身抗体的检测分析

目的探讨自身免疫性甲状腺疾病(AITD)患者血清抗甲状腺球蛋白抗体(TGAb)及抗甲状腺过氧化物酶抗体(TPOAb)的含量变化及两抗体的临床应用价值。方法采用AXSYM全自动免疫发光分析仪对77例甲状腺功能亢进、38例原发性甲状腺功能减退、44例桥本甲状腺炎和58例正常对照的血清TGAb和TPOAb含量进行检测分析。结果甲状腺功能亢进组、原发性甲状腺功能减退组和桥本甲状腺炎组的TGAb、TPOAb的含量和异常率均高于正常对照组(P<0.01)。将甲状腺功能亢进组、原发性甲状腺功能减退组和桥本甲状腺炎组三组间的TGAb、TPOAb含量和异常率相比较,可以发现含量和异常率呈上升趋势(P<0.05)。结论 AITD患者的血清TGAb和TPOAb含量存在明显异常升高,两者是临床诊断AITD有用的实验室指标。     

血清TGAb、TPOAb在甲状腺疾病中的应用价值

目的探讨甲状腺球蛋白抗体(TGAb)和甲状腺过氧化物酶抗体(TPOAb)水平在甲状腺功能亢进(甲亢)和原发性甲状腺功能减退症(甲减)中的改变及其临床意义。方法将100例甲亢患者分成4组:甲亢初诊组、甲亢复发组、甲亢缓解组和治疗后转向甲减组。采用免疫化学发光法分别检测100例甲亢、60例原发性甲减患者和30例正常人的血清TGAb和TPOAb。结果甲亢组和原发性甲减组的TGAb和TPOAb阳性率与正常组比较差异均有统计学意义(P<0.01);100例甲亢患者治疗前后TPOAb阳性率明显高于TGAb的阳性率;无论是初诊组、复发组还是缓解组治疗前后两种抗体检测的阳性率比较,差异均有统计学意义(P<0.05)。结论 TGAb和TPOAb的定量检测在甲状腺疾病的鉴别、诊断及治疗中具有参考价值,TPOAb具有相对较高的临床价值。     

甲状腺自身抗体在自身免疫性甲状腺疾病诊断中的应用价值

目的 探究甲状腺自身抗体在自身免疫性甲状腺疾病(AITD)诊断中的应用价值.方法 选择2019年5月至2020年5月我院收治的80例AITD患者作为AITD组,其中34例为桥本甲状腺炎(HT),46例为毒性弥漫性甲状腺肿(Graves病);另选取同期我院50例健康体检者作为对照组.比较各组的促甲状腺激素受体抗体(TRA...     

儿童自身免疫性甲状腺疾病的诊治

自身免疫性甲状腺疾病（ATDs）主要包括自身免疫性甲状腺炎（AT）及Graves病（GD）,均由T淋巴细胞的浸润及B淋巴细胞产生甲状腺自身免疫性抗体引起甲状腺功能异常。甲状腺功能对儿童的神经系统及生长发育至关重要,因此早期诊治十分必要。本文旨在对儿童自身免疫性甲状腺疾病的病因、诊断及治疗进行探讨。     

High prevalence of thyroid hormone autoantibody and low rate of thyroid hormone detection interference

ObjectiveThyroid hormone autoantibody (THAb) is a common antibody in autoimmune disease and can interfere with the detection of thyroid hormone (TH). There was no research reporting the prevalence of THAb in Chinese and the rate of THAb interfering with TH detection.MethodsWe collected 114 patients with autoimmune thyroid disease (AITD) (Hashimoto''s thyroiditis, 57 cases; Graves’ disease, 57 cases), 106 patients with nonthyroid autoimmune diseases (NTAID), and 120 healthy subjects. According to the presence or absence of thyroid antibodies, patients with NTAID were divided into two groups: NTAID‐AITD and NTAID groups. Radioimmunoprecipitation technique was used to detect THAb in all subjects. TH was detected on Abbot and Roche platforms in patients with positive THAb.ResultsThe prevalence of THAb was 22.8% in Hashimoto''s thyroiditis and 45.6% in Graves’ disease. The prevalence of THAb in AITD group was lower than that in NTAID or NTAID‐AITD groups (34.2% vs. 61.5%, p = 0.014; 34.2% vs. 71.3%, p < 0.01). Among total 98 patients with positive THAb, TH levels of 9 patients were falsely elevated (9.18%).ConclusionThe prevalence of THAb in AITD patients was lower than that in NTAID patients. Although THAb had a high frequency in various autoimmune diseases, the prevalence of THAb interfering with TH detection was only 9.18%.     

p53 codon 72 proline/arginine polymorphism and autoimmune thyroid diseases

p53 protein participates in the processes of apoptosis, which is involved in a number of immunological reactions. In order to test whether the p53 gene could be used as a genetic marker for the prediction of the development of autoimmune thyroid diseases (AITD), we screened, by using polymerase chain reaction (PCR) analysis, for the C (CCC)/G (CGC) polymorphism at the p53 codon 72 (Pro 72/Arg 72) to determine the genotypes of 107 Hashimoto's thyroiditis (HT) and 90 Graves' disease (GD) patients, and 105 normal controls. The data demonstrated that, for the genotype analysis, HT patients featured an enhanced numerical ratio for the Arg/Arg homozygous genotype (33.7%) and a diminished ratio for the Arg/Pro heterozygous genotype (41.1%) at the p53 codon 72 than was the case for normal controls (Arg/Arg: 17.1% and Arg/Pro: 61.9%; P=0.005). The odds ratio for the risk of the Arg/Arg genotype's appearance, compared with that of the Arg/Pro and Pro/Pro genotypes combined, for the HT patient group was 2.450 (95% confidence interval: 1.274-4.716). With respect to allelic analysis, we did not observe significant difference in the frequency of appearance of the Arg allelic variant and the Pro allelic variant for the p53 codon 72 when comparing the HT patient group with the control group (P=0.208). On the other hand, GD patients presented no significant difference in distribution for both genotype and allelic frequencies (P=0.344 and 0.245, respectively) when compared with normal controls. In conclusion, HT patients feature a greater ratio of arginine homozygosity at p53 codon 72 than in the case for normal subjects. The p53 codon 72 proline/arginine polymorphism may be a genetic marker to predict the increased susceptibility of development of HT.     

Antiphospholipid antibodies in autoimmune thyroid diseases

BackgroundAntiphospholipid (aPL) antibodies have been reported in several autoimmune diseases. The aim of this study was to evaluate the frequency of aPL (anti‐cardiolipin antibodies (aCL) and anti‐β2 glycoprotein I antibodies (aβ2GPI)) in patients with autoimmune thyroid diseases (AITD).MethodsOne hundred and ninety‐five patients with AITD (139 Hashimoto''s thyroiditis (HT) patients and 56 Graves'' disease (GD) patients) and 90 healthy blood donors (HBD) were studied. IgG, IgA and IgM aCL and aβ2GPI were determined by ELISA.ResultsOne hundred fifty‐four AITD patients were women and 41 were men. Fifty‐six healthy subjects were women and 34 were men. The median age of patients and the control group was 45 and 38.5 years, respectively. The frequency of aPL was significantly higher in patients with AITD and in patients with HT than in HBD (33.3% vs 11.1%, p < 10⁻³ and 38.1% vs 11.1%, p < 10⁻³). The frequency of aPL in GD was significantly lower than in HT (21.4% vs 38.1%, p = 0.025). In patients with HT, aβ2GPI (34.5%) was significantly more frequent than aCL (13.6%) (p < 10⁻³). The frequency of aβ2GPI was significantly higher in patients with HT than in healthy population (34.5% vs 11.1%, p < 10⁻³). In HT patients, IgA isotype of aβ2GPI was significantly more common than in HBD and in GD patients (27.3% vs 7.8%, p < 10⁻³ and 27.3% vs 12.5%, p = 0.02, respectively).Conclusionaβ2GPI and not aCL were frequent in AITD. IgA was the predominant isotype of aβ2GPI. aβ2GPI‐IgA was more frequent in HT than in GD.     

甲状腺疾病红细胞碳酸酐酶测定的临床意义

目的探讨甲状腺疾病患者甲状腺激素水平与红细胞碳酸酐酶(CA)浓度的关系。方法对38例甲状腺疾病患者包括Graves病组20例,原发性甲状腺功能减退症组(甲减组)10例,桥本甲亢组8例,随访4个月,观察甲状腺激素水平与红细胞CA浓度的变化,与28例健康对照进行比较。结果①Graves病组0、4、8周红细胞CA均低于对照组(P<0.001),至12周升至正常范围(P>0.05);甲减组与桥本甲亢组红细胞CA水平在0、4、12周均与对照组相似(P>0.05)。②入选时Graves病组与桥本甲亢组总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)水平相似(P>0.05),红细胞CA浓度Graves病组低于桥本甲亢组(P<0.05)。③Graves病组TT3、TT4恢复正常的比率在4、8、12周均高于0周(P<0.05),红细胞CA恢复正常的比率在4、8周均与0周相似(P>0.05),在12周时高于0周(P<0.001)。结论①红细胞CA浓度可用于鉴别Graves病及桥本甲亢患者的甲状腺毒症,对指导治疗具有一定意义。②红细胞CA浓度可反映甲状腺疾病患者8周前的甲状腺激素平均水平。     

自身免疫性肝病抗体在肝病诊断中的临床价值

目的探讨自身免疫性肝病抗体在肝病诊断中的临床价值。方法回顾性分析2145例肝病患者的自身抗体结果,并对自身抗体阳性的结果进行临床分析。结果 2145例患者中共检测出自身抗体阳性359例,阳性率为16.7%。诊断原发性胆汁性肝硬化（PBC）64例,检出率为3.0%,诊断自身免疫性肝炎（AIH）59例,检出率为2.8%。73.4%PBC患者血清抗核抗体（ANA）≥1∶320,且26.6%抗线粒体抗体（AMA）为阳性;49.2%AIH患者血清ANA≥1∶320,且3.3%AMA为阳性。PBC患者核膜型及着丝点型显著多于AIH患者,而均质型及着丝点颗粒型显著少于AIH患者,差异均有统计学意义。ANA阳性≥1∶320乙型肝炎患者谷丙转氨酶（ALT）、谷草转氨酶（AST）、谷酰转肽酶（GGT）及碱性磷酸酶（ALP）水平显著高于ANA阳性≥1∶100及ANA阴性患者,差异有统计学意义。结论自身抗体检测是诊断自身免疫性肝病的必要条件,但需鉴别病毒性肝炎、药物性肝炎和其他疾病。     

Assessment of serum dipeptidyl peptidase-IV levels in autoimmune thyroid disease

ObjectiveDecreased serum dipeptidyl peptidase-IV (sDPPIV) levels have been reported in patients with autoimmune diseases. However, few studies have analyzed the association between sDPPIV levels and autoimmune thyroid disease (AITD). This study aimed to evaluate the association between sDPPIV levels and three types of AITD: Graves’ disease (GD), Graves’ ophthalmopathy (GO), and Hashimoto’s thyroiditis (HT).MethodsPatients newly diagnosed with GD (n = 65), GO (n = 22), and HT (n = 27) and healthy individuals (n = 30) were recruited. Clinical characteristics and thyroid function data were collected. sDPPIV was measured using enzyme-linked immunosorbent assays.ResultsCompared with controls (786.3 ± 46.95), patients with GD and GO had significantly lower sDPPIV levels (662.2 ± 38.81 and 438.4 ± 31.78). Additionally, sDPPIV levels were negatively associated with antithyroid peroxidase antibody (r = −0.20) and antithyroglobulin antibody (r = −0.19), but there was no significant relationship between thyroid hormone and sDPPIV levels. GO cases were divided by proptosis with and without muscle thickening; sDPPIV levels were lower in the muscle thickening group than those in the without muscle thickening group. Logistic regression analysis showed that sDPPIV was negatively correlated with GO and GD.ConclusionssDPPIV concentrations were abnormal in patients with GD and GO, and reduced sDPPIV expression may be involved in the progression of GO and GD.