摘要
为探讨化学发光免疫分析法 (CLIA)测定血清抗甲状腺球蛋白抗体 (抗TgAb)和抗甲状腺过氧化物酶抗体 (抗TPOAb)的临床诊断价值 ,以病理诊断作为主要依据 ,2 89例各种甲状腺疾病患者为研究对象 ,采用CLIA法测定血清抗TgAb、抗TPOAb水平 ,应用ROC曲线分析法评价CLIA法的诊断价值并确定诊断临界值。结果发现对自身免疫性甲状腺疾病 (AITD)的诊断 ,血清抗TgAb和抗TPOAb水平的ROC曲线下面积分别为 0 792± 0 0 2 9和 0 892±0 0 2 2 ,其诊断临界值分别为 90U mL(准确度 75 1% ,敏感度 6 3 3% ,特异度 82 2 % )和 30 0U mL(准确度 85 5 % ,敏感度 78 9% ,特异度 89 4 % )。特别针对桥本病的诊断 ,血清抗TgAb和抗TPOAb曲线下面积分别为 0 76 9± 0 0 4 4和 0 737± 0 0 4 9,诊断临界值分别为 30 0U mL(准确度 6 9 7% ,敏感度 5 4 9% ,特异度 82 8% )和 30 0 0U mL(准确度74 3% ,敏感度 70 6 % ,特异度 77 6 % ) ,总预测正确率为 71 6 % ,总判别功效为 6 9 7% ,增加血清TSH水平变量后 ,总预测正确率和总判别效力均提高至 89 9%。表明CLIA法测定血清抗TgAb和抗TPOAb水平对AITD诊断具有较高的诊断价值 ;对桥本病和Graves病的诊断 ,如同时参考血清促甲状腺激素 (TSH)水平 ,可明显提高诊断的准确度。
To evaluate the clinical diagnostic value of anti-thyroperoxidase antibody (anti-TPOAb) and anti-thyroglobulin antibody (anti-TgAb) by chemiluminescence immunoassay (CLIA). Serum levels of anti-TPOAb and anti-TgAb were assayed using the ACS: 180 automated Chemiluminescence Immunoassay System supplied by Bayer Corporation in 289 subjects, including 51 patients with Hashimoto's disease, 58 with Gravesdisease, 68 with nodular goiter, 56 with thyroid adenoma and carcinoma and 56 with subacute thyroiditis?The diagnostic effects of autoimmune thyroid diseases (AITD) and non-AITD, Hashimotos disease and Graves disease were evaluated by the receiver operating characteristic (ROC) curve and discriminant analysis. The results revealed that in diagnosis of AITD and N-AIrTD, with the cut-off points of 90U/mL for TgAb and 300U/mL for TPOAb, the highest of the accuracy of AITD was obtained (the under-curve area of anti-TgAb and anti-TPOAb were 0.792 0.029and 0.892 0.022). The diagnostic accuracy was lower in the diagnosis of Hashimoto's disease and Graves' disease. It rose to 89.9% of diagnostic accuracy when the serum level of TSH was included. The study demonstrated that anti-TPOAb and anti-TgAb assay by CLIA appeared to be an accurate, sensitive, and specific method for AITD diagnosis.
出处
《基础医学与临床》
CSCD
北大核心
2004年第4期452-456,共5页
Basic and Clinical Medicine
关键词
临床诊断
血清
特异度
CLIA
AITD
发光免疫分析
桥本病
价值
增加
预测
anti-thyroperoxidase antibody
anti-thyroglobulin antibody
autoimmune thyroid diseases
chemiluminescence assay
ROC curve
