1171例甲状腺疾病患者TMA,TGA检测的临床意义

本文对1994～1998年确诊的1171例甲状腺疾病患者作了TGA(甲状腺球蛋白抗体),TMA(甲状腺微粒体抗体)的联合测定,以探讨其临床意义。 材料和方法 一、对象:正常组:均为我院门诊体检合格的健康人228例(女158,男70)。年龄9～55岁。甲状腺疾病组1171例(男271,女900)。其中桥本氏甲状腺炎236例(男80,女156),桥本氏甲亢142例(男13,女129),甲亢368例(男92,女256),甲减126例(男21,女105),单纯甲肿213例(男51,女162),甲状腺瘤86例(男35,女51)。均系门诊及住院的已确诊的     

血清补体溶解免疫复合物能力与小儿肾小球疾病的关系

测定了７４例肾小球疾病患儿血清补体溶解免疫复合物能力（ＣＭＳＣ）．结果为单纯性肾病患儿血清ＣＭＳＣ无明显变化，急性肾炎、肾炎性肾病和紫癜性肾炎患儿血ＣＭＳＣ显著下降；除急性肾炎患儿血ＣＭ－ＳＣ与血ＣＨ＿５０、Ｃ＿３、Ｃ＿４呈正相关外，其他疾病患儿未发现相关性。     

甲型肝炎患者循环免疫复合物的检测及其临床意义

本文对20例甲肝病人血清用聚乙二醇组分分析法进行了循环免疫复合物(CIC)的检测,发现:(1)甲肝急性期IgM抗体和IgM型CIC明显增高,且IgM型CIC与抗HAV-IgM效价存在着明显的正相关,间接提示抗体IgM以甲肝病毒作为抗原形成CIC(循环免疫复合物),参与病毒的排除。(2)病人血清中CIC水平变化与病情有一定的关系。     

自身免疫性甲状腺疾病胰岛素样生长因子及其结合蛋白的改变

为探讨胰岛素样生长因子 (IGF )、胰岛素样生长因子结合蛋白 (IGFBP )在自身免疫性甲状腺疾病 (AITD )中的变化及其影响 ,本研究检测了 5 6例AITD患者与 2 4例正常对照血清IGF 1、IGFBP 1～ 3及甲状腺功能 ,发现IGF 1在GD、HT与GD控制组明显低于正常对照 (P <0 0 1) ,IGFBP 1、IGFBP 2在GD组明显高于正常对照 (P <0 0 1,0 0 5 ) ,IGFBP 3在HT组明显低于正常对照 (P <0 0 5 ) ;IGF 1与甲状腺激素间无相关 ,IGFBP 1～ 3均与TT4相关 (r =0 34、 0 38、 0 31;P <0 0 5 )。提示机体甲状腺激素、免疫状态均可能影响IGF、IGFBP水平 ,而后者有可能参与调节AITD的进程。     

化学发光免疫分析法在甲状腺疾病诊断中的应用

目的 探讨化学发光免疫分析法在甲状腺疾病诊断中的应用。方法 选取2017年5月~2018年5月我院接收的甲状腺疾病患者63例作为研究对象,按照疾病类型分为实验1组（甲状腺肿瘤患者）、实验2组（甲状腺功能亢进患者）、实验3组（其他甲状腺疾病患者）,每组21例;另选取同期来我院健康体检人员21名作为对照组。所有研究对象均实施化学发光免疫分析法、放射免疫法评估甲状腺球蛋白水平、假阴性、假阳性及符合率、敏感度、特异度。结果 实验1、2、3组甲状腺球蛋白水平高于对照组,四组放射免疫法检测的甲状腺球蛋白低于化学发光免疫法,差异有统计学意义（P＜0.05）。四组假阴性、假阳性、符合率、敏感度、特异度比较,差异无统计学意义（P＞0.05）;化学发光免疫法检测结果优于放射免疫法,差异有统计学意义（P＜0.05）。结论 在甲状腺疾病临床检验中,化学发光免疫分析法比放射免疫法更具有优势,其操作简单,且对甲状腺疾病有极高的敏感度、特异度。     

甲状腺球蛋白测定在甲状腺疾病中的临床意义

对我院2007年3月～2008年12月甲状腺疾病甲状腺球蛋白（TG）检查1312例,现分析报告如下。     

IgG对补体介导的免疫复合物溶解能力的影响及其在肾脏疾病治疗中的意义

本文观察不同浓度人IgG对补体介导的免疫复合物溶解能力(Complement-mediated immune complex solubilizig capacity,CMSC)的影响。对照组为人血清白蛋白(HSA)、牛血清白蛋白(BSA)以及PBS,所用复合物为BSA-抗BSA。结果证实IgG及HSA浓度增高对正常血清的CMSC有抑制作用;BSA可促使免疫复合物(Immune complex,IC)解离,但浓度超过10g/L,BSA-抗BSA复合物的溶解率也随之下降。作者认为用大剂量免疫球蛋白治疗IC介导的肾脏疾病,尚需对其适应症和剂量作进一步研究。     

检测循环免疫复合物的快速ELISA捕捉法

以兔抗日本脑炎病毒(JEV) IgG与JEV形成的免疫复合物(IC)为模型,羊抗兔IgG为包被抗体,辣根过氧化物酶标记的JEV种特异性单抗为结合物,通过选择适宜的试验条件,建立了检测IC的快速ELISA捕捉法(RICC-ELISA);并初步用于检测感染JEV的恒河猴多次注射单抗后,猴抗鼠IgG及IgM与单抗形成的IC的动态变化.应用该法,在60分钟内就可得出结果,具有快速、简便、特异、敏感等特点,并可推广应用,检测其它类型的IC.     

自身免疫性甲状腺疾病患者外周血淋巴细胞端粒长度的研究

目的：研究自身免疫性甲状腺疾病（ATD）患者外周血淋巴细胞端粒长度的变化。方法：用流式原位杂交法检测38例ATD患者和48例健康对照者外周血淋巴细胞的端粒长度。结果：患者组外周血淋巴细胞端粒长度明显短于健康对照组（P＜0．001）,端粒长度与病程、发病时间、甲状腺激素水平不相关。健康对照组端粒长度随年龄增加而变短,病人组端粒长度与年龄不相关。结论：ATD病人的外周血淋巴细胞端粒长度比正常人短,且与年龄不相关,提示其外周血淋巴细胞复制、分裂增多及凋亡异常。     

The Cryptic Self in Thyroid Autoimmunity: The Paradigm of Thyroglobulin

Recent studies have increased the number of known thyroiditogenic sites in thyroglobulin (Tg) to thirteen. These sites contain T-cell epitopes and are scattered throughout Tg, with nine of them localized toward the carboxyl terminal third of the molecule. So far, no pathogenic determinant has been found to be dominant, i.e. to be readily and consistently generated in extrathyroidal antigen-presenting cells (APC) following processing of intact Tg in vivo and in vitro. However, certain conditions, such as internalization of Tg-antibody complexes or enhanced iodination of Tg, have been described to promote generation of cryptic pathogenic peptides in APC, in vitro. These findings support the view that post-translational events can “unmask the cryptic self” and suggest mechanisms that may contribute to the pathogenesis of thyroiditis.     

自身免疫性甲状腺疾病患者甲状腺自身抗体与纤维化四项联检的临床价值分析

目的探讨利用自身免疫性甲状腺疾病患者中,血清甲状腺过氧化物酶抗体(TPOAb)及甲状腺球蛋白抗体(TgAb)水平联合血清纤维化四项检测,评价甲状腺组织纤维化的临床价值分析。方法选取我院就诊的174例患者,甲状腺相关自身抗体异常增高作为病例组;选取在我院体检科健康体检者25例,甲状腺相关自身抗体均正常作为对照组。采用化学发光法测定TPOAb、TgAb;采用放射免疫法检测纤维化四项包括:血清层黏蛋白(LN)、血清透明质酸(HA)、血清Ⅲ型前胶原氨端肽(PⅢNP)、血清IV胶原(CIV)。采用SPSS 21.0软件进行方差分析(ANOV)和t检验;Pearson相关性分析TPOAb、TgAb分别与纤维化四项的关系。结果阳性组与对照组、超声影像不同表现组比较,纤维化指标水平差异无统计学意义;血清TPOAb、TGAb分别与PⅢNP、CIV、LN、HA进行相关性分析(P>0.05),呈显著无相关。结论甲状腺自身抗体异常患者,甲状腺功能正常情况下,纤维化指标检测用于判断甲状腺纤维化的意义不大。     

Induction of Peroxidase and Thyroglobulin by TSH in Cultured Thyroid Cells from Patients with Basedow's Disease and Its Inhibition by Actinomycin D

The effects of TSH on peroxidase activity (PO) and thyroglobulin (TG) production were investigated using primary cultures of thyroid cells obtained from patients with Basedow's disease (Basedow's cells). PO activity of cultured cells and TG concentration in the culture medium were measured by biochemical and sandwich enzyme immunoassays, respectively. The addition of TSH (10 mU/ml/day) to the medium did not increase the cell number but did increase the PO activity and TG concentration. It took more than 3 days for the PO activity of cells cultured with TSH (stimulated group) to reach a level twice that of cells cultured without TSH (control group), whereas 2 days of incubation with TSH was sufficient for increasing the TG concentration. When actinomycin D (AD) was added to the medium on the first day of 3-day incubation with TSH, the stimulatory effect of TSH on PO was completely blocked and the TG concentration was reduced to half that of the control group. AD given to the stimulated group on the last day of induction produced no inhibitory effect on the induction of PO activity by TSH, but reduced the TG concentration to almost half that in the stimulated group. An electron microscopic study of Basedow's cells cultured with AD and TSH failed to reveal any cytopathic change. The findings of the present study suggested that in cultured Basedow's cells TSH induces PO activity and TG production through the synthesis of new messenger RNA.     

健康宣教在甲状腺疾病手术患者中的应用

目的：对甲状腺疾病患者或家属实施有效的健康教育,使患者心理状态和配合程度均达到最佳状态,让后期治疗平稳。方法2012年4月~2013年8月对30例甲状腺手术患者针对的进行多形式的健康教育院包括病情观察、心理指导、术前、术后功能锻炼、用药的注意事项等贯穿于整个住院期间直至出院。结果通过对30例甲状腺疾病患者实施健康宣教后,均能正确认识疾病,积极配合治疗,以一种积极的心态回归社会。结论从而提高了生活质量及社会适应能力。     

Clinical Outcome of Remnant Thyroid Ablation with Low Dose Radioiodine in Korean Patients with Low to Intermediate-risk Thyroid Cancer

Radioiodine activity required for remnant thyroid ablation is of great concern, to avoid unnecessary exposure to radiation and minimize adverse effects. We investigated clinical outcomes of remnant thyroid ablation with a low radioiodine activity in Korean patients with low to intermediate-risk thyroid cancer. For remnant thyroid ablation, 176 patients received radioiodine of 1.1 GBq, under a standard thyroid hormone withdrawal and a low iodine diet protocol. Serum levels of thyroid stimulating hormone stimulated thyroglobulin (off-Tg) and thyroglobulin-antibody (Tg-Ab), and a post-therapy whole body scan (RxWBS) were evaluated. Completion of remnant ablation was considered when there was no visible uptake on RxWBS and undetectable off-Tg (<1.0 ng/mL). Various factors including age, off-Tg, and histopathology were analyzed to predict ablation success rates. Of 176 patients, 68.8% (n = 121) who achieved successful remnant ablation were classified into Group A, and the remaining 55 were classified into Group B. Group A presented with significantly lower off-Tg at the first radioiodine administration (pre-ablative Tg) than those of Group B (1.2 ± 2.3 ng/mL vs. 6.2 ± 15.2 ng/mL, P = 0.027). Pre-ablative Tg was the only significant factor related with ablation success rates. Diagnostic performances of pre-ablative Tg < 10.0 ng/mL were sensitivity of 99.1%, specificity of 14.0%, positive predictive value of 71.1%, and negative predictive value of 87.5%, respectively. Single administration of low radioiodine activity could be sufficient for remnant thyroid ablation in patients with low to intermediate-risk thyroid cancer. Pre-ablative Tg with cutoff value of 10.0 ng/mL is a promising factor to predict successful remnant ablation.

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Immunohistochemical Demonstration of Epidermal Growth Factor Receptor and Ceruloplasmin in Thyroid Diseases

The expression of epidermal growth factor receptors (EGFR) and ceruloplasmin (CP) in thyroid diseases was investigated by immunohistochemical methods, and the results were compared with the expression of thyroglobulin (TG). Eighty eight surgical specimens of thyroid diseases, including follicular carcinoma (7 cases), papillary carcinoma (20 cases), follicular adenoma (29 cases), adenomatous goiter (10 cases), diffuse hyperplasia (20 cases) and chronic thyroiditis (2 cases), were studied. All cases of follicular carcinoma and 18 cases (90%) of papillary carcinoma expressed the EGFR immunoreaction in the cytoplasm with a moderate to strong staining intensity. A weak immunoreaction for EGFR was noted in some benign thyroid diseases. CP showed various degrees of positivity in all cases of follicular carcinoma and 19 cases (95%) of papillary carcinoma. The benign thyroid lesions were consistently negative for this antigen, not counting one case of Hiirthle cell adenoma. There was a positive correlation between EGFR and CP immunostaining intensity in thyroid carcinomas, representing higher expression of EGFR accompanied by a stronger staining intensity of CP. Except for two cases of papillary carcinoma, all cases showed immunoreaction for TG. The results indicate the enhanced expression of EGFR and CP in thyroid carcinomas. EGFR and CP thus appear to be valuable tools for differential diagnosis between benign and malignant thyroid neoplasms.     

血清抗甲状腺球蛋白抗体和抗甲状腺过氧化物酶抗体检测在甲状腺疾病诊断及甲亢预后判断中的价值

采用放免法检测甲状豚疾病患者抗甲状腺球蛋白抗体（ＴＧＡｂ）和抗甲状腺过氧化物酶抗体（ＴＰＯＡｂ）、并对部分Ｇｒａｖｅｓ病患者停药后随诊一年的结果进行分析。结果显示：（１）自身免疫性甲状腺疾病患者ＴＧＡｂ和ＴＰＯＡｂ活性及阳性率明显高于非ＡＩＴＤ，尤以桥本甲状腺炎为然。（２）ＧＤ治疗前及停药时ＴＧＡｂ和ＴＰＯＡｂ均阴性者与均阳性者停药一年内的复发率分别为０．５８３和０．２３１。（３）ＴＧＡｂ和ＴＰＯＡｂ均阴性，而停药时甲状腺刺激抗体（ＴＳＡｂ）阳性者，停药时ＧＤ复发的机率最大（０．９０９），提示ＴＧＡｂ和ＴＰＯＡｂ检测在ＡＩＴＤ诊断，鉴别诊断以及ＧＤ预后判断中具有重要的临床意义。     

甲状腺球蛋白测定与131I全身显像在甲状腺乳头癌复发监测中的意义

探讨甲状腺球蛋白(Tg)和131I全身显像(131I-WBS)在甲状腺乳头癌(PTC)复发监测中的意义. 30例PTC患者术后6周,行131I(3.7GBq)首次清除残留甲状腺组织治疗,6个月后再给予131I 治疗1次,治疗中同时测定Tg和进行131I-WBS.结果表明,在首次清除残留甲状腺组织治疗时,显像发现淋巴、肺及骨转移6例,其余转移灶于6个月治疗时发现,有3例患者(10%)Tg测定在正常范围,而131I-WBS出现转移灶,4例患者(13.3%)Tg测定异常,而131I-WBS正常.Tg测定和131I-WBS可作为诊断PTC有无转移的重要指标,二者监测复发应联合应用,可互相补充.     

流行性出血热病人血清和肾组织中存在IgE型免疫复合物

本文应用ELISA(双抗体夹心)法检测了EHF病人血清中IgE及其IgE型免疫复合物;应用免疫酶纽化法检测EHF尸体肾脏沉积的IgE型免疫复合物。结果发现各病日组病人血清中IgE和[gE型免疫复合物的含量显著地高于正常人。IgE水平以3～5病日者为最高,IgE型免疫复合物以6～10病日最高。EHF尸体肾脏组织中有IgE型免疫物沉积。这说明EHF病人血中有IgE型免疫复合物形成,可随血流沉积于肾组织,参与EHF中、晚期发病过程。