异嗜性抗体对甲状腺功能测定干扰作用的研究

目的 研究异嗜性抗体(HAb)对甲状腺功能测定的干扰,分析其临床特点并探讨减少和排除干扰作用的方法.方法 2008年5月-2009年6月,在我院选择296例甲状腺功能测定表现为血浆TSH水平不适当增高的患者(FT3、FT4测定采用固相放射免疫分析方法,TSH测定采用免疫放射分析方法-IRMA),其中9例疑诊HAb增多症...

Heterophile antibody interference in thyroid function assay

Objectives To analyze heterophilic antibody （HAb） interference in thyroid function assay and investigate the methods of reducing or eliminating the interference. Methods 296 patients with inappropriately elevated thyrotropin levels were selected form May 2008 to June 2009. Serum FT3 ,FT4 were measured with solid-phase radioimmun assay and TSH with immunoradiometric assay （IRMA）, all the results had been verified by retesting. At the same time, radioimmune assay （RIA） was used to examine serum TSH level of the same samples. After interference probably from rheumatoid factor （RF） was excluded by ratenephelometry, 9 cases of the all patients were found with suspectably increased HAb, the concentrations of serum FT3 ,FT4 ,TSH were further assayed via adding non-immune animal sera from different species. Results （1）The concentrate of TSH with RIA was significantly lower than that with IRMA in the 9 increased heterophile antibody cases （ P 〈 0.05） ,but there was no obvious difference between the concentrate of TSH with RIA and concentrate of TSH with IRMA in the 287 rest patients with elevated TSH level（P 〉 0.05 ）. （2）In the 9 increased heterophile antibody cases after HAb was neutralized by non-immune animal sera, the level of TSH was remarkable reduced （ P 〈 0.05 ） , but there was no obvious difference between the concentrate of TSH with IRMA and concentrate of TSH with IRMA in the 287 rest patients after HAb was neutralized by non-immune animal sera （ P 〉0.05 ）. （3）The values of serum FT3, FT4with RIA and The values of serum FT3 with RIA after HAb was neutralized by non-immune animal sera were still kept in nearly constant levels in the 9 increased heterophile antibody cases （ P 〉 0.05 ）. （4）The values of serum FT3, FT4with RIA and The values of serum FT3 with RIA after HAb was neutralized by non-immune animal sera were still kept in nearly constant levels in the 287 rest patients （ P 〉 0. 05）. Conclusions Heterophile antibody can interfere in the non-competitive two-site immunoassay such as IRMA, and cause the falsely elevated TSH level. Competitive RIA was not susceptible to the interference caused by heterophile antibody. The non-immune animal sera can neutralize and attenuate the interference of HAb.