摘要
目的观察甲状腺过氧化物酶抗体（TPO Ab）、甲状腺球蛋自抗体（TG Ab）和甲状腺微粒体抗体（TM Ab）在自身免疫性甲状腺疾病（AITD）中的改变．探讨TPO Ab存临床诊断和治疗上的作用和意义方法收集AITD患者．根据甲状腺功能不同分为甲状腺功能亢进（简称甲亢）组（Graves病、GD，57例）、甲低组（桥本氏甲状腺炎、HT．48例）、亚甲低组（41例）和AITD复诊组（甲状腺功能恢复正常1～6个月，41例）。另取一级亲属无GD或HT的健康人群53例为对照组。采用放射免疫分析法检测血清中甲状腺自身抗体（TPO Ab、TG Ab和TM Ab）及甲状腺激素和促甲状腺激素（FT3、FT4，sTSH）水平。结果甲亢组、甲低组和亚甲低组中TPO Ab阳性率（87．70％、97．20％、100．00％）均明显高于同组内TG Ab阳性率（43．90％、60．42％、48．78％）和TM Ab阳性率（43．90％、79．10％、60．98％）；3种甲状腺自身抗体的阳性率和阳性患者的抗体水平均高于相应的对照组。AITD复诊组的TPO Ab阳性患者的抗体水平[（683．04±606．55）kU／L]明显低于甲亢组、甲低组和亚甲低组[（1049．31±941．00）、（106440．79±272．38）、（5133．01±4449．67）kU／L]。结论TPO Ab在AITD的诊断更具有代表意义。
Objective To study the behavior of Thyroid peroxidase antibodies（TPO Ab） ,thyroglobulin antibodies （TG Ab） and thyroid microsomal antibodies （TM Ab） in autoimmune thyroid diseases（AITD） aiming at further understanding of their important clinical value. Methods AITD Patients were divided into four groups according to their thyroid functions： hyperthyroid group （GD patients）, hypothyroid group （HT patients）, subclinical hypothyroid group and restored thyroid function group（patients who once suffered AITD but now thvroid function was restored for 1 to 6 months）, while a certain number of healthy blood donors taken as control were enrolled in our experiment. The levels of TPO Ab, TG Ab and TM Ab as well as thyroid-relevant hormones were measured by radioimmunoassay. Results In hyperthyroid group presenting high FT3, high FT4, low sTSH, hypothyroid group with low FT3, low FT4, high TSH and subclinical hypolhyroid group with normal FT3, normal FT4, high sTSH, the positive rate of TPO Ab was 87.7% ,97.2% and 100%, higher than those of TG Ab（43.90% ,60.42% and 48.78% ） and TM Ab（43.90%, 79.1% and 60.98%） respectively （P 〈 0.01） when the comparison was made in the same group, and the positivity rate and the average positive level of the patients with positive thyroid autoantibodies positive in each group were remarkably higher than those of control group respectively, P 〈 0.01. In restored thyroid function group with normal FT3, normal FT4, normal sTSH, the average positive level of TPO Ab[ （683.04 ± 606.55）kU/L] was significantly decreased when compared with hyperthyroid group, hypothyroid group and subclinical hypothyroid group separately [ （ 1049.31 ± 941.00 ）, （ 106 440.79 ± 272.38 ）, （5133.01 ± 4449.67 kU/L） i while no statistical differences of the positive levels of both TG Ab and TM Ab were found. Conclusion TPO Ab is of greater clinical value than TG Ab and TM Ab in diagnosing AITD for those patients with thyroid dysfunction, which an important indicator instructing the treatment and prognosis of AITD.
出处
《中国地方病学杂志》
CAS
CSCD
北大核心
2007年第3期316-319,共4页
Chinese Jouranl of Endemiology
基金
国家自然科学基金重点资助项目（30230330）
天津市科技发展计划项目（05YFGDSF02700）
天津市高等学校科技发展基金项目（2004ZD08）
