摘要
目的回顾性分析高分辨超声联合血清甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)在甲状腺功能正常桥本甲状腺炎(HT)患者中的诊断效能,旨在为该病筛查提供思路。方法收集苏州市第九人民医院2019年1月至2021年12月因甲状腺结节或甲状腺肿而进行检查或治疗的98例患者资料,以甲状腺手术病理证实为标准,将患者分为HT与非HT。分析并比较HT与非HT患者术前甲状腺功能指标水平,血清TAPOb与TgAb水平,同时观察高分辨超声(HRUS)检查情况。结果98例患者中,手术证实单纯或合并恶性肿瘤HT患者24例,非HT患者74例,TPOAb、TgAb水平比较,HT患者高于非HT患者(P<0.05)。诊断效能评估,单独TPOAb检查特异度高于其他检查,TPOAb联合TgAb检查符合率最高,TPOAb+TgAb+HRUS灵敏度高于其他检查,且ROC曲线图下降面积最大。在与手术病理对HT检查一致性中,TPOAb联合TgAb检查有高度一致性(kappa系数=0.687)。结论在甲状腺功能正常HT患者诊断中,采用HRUS与血清TPOAb、TgAb诊断各具优势,TPOAb联合TgAb检查具有较高的准确性,与手术证实的一致性较好,但TPOAb、TgAb、HRUS联合能够发挥最大的诊断效能,对术前HT筛查的灵敏度更高。
Objective To retrospectively analyze the diagnostic efficacy of high-resolution ultrasound(HRUS)combined with the detection of serum thyroglobulin antibody(TgAb)and thyroid peroxidase antibody(TPOAb)in patients with Hashimoto’s thyroiditis(HT)with normal thyroid function,thus providing ideas for the screening of HT.Methods Clinical data of 98 patients who underwent examination or treatment for thyroid nodules or goiter in Suzhou Ninth People’s Hospital from January 2019 to December 2021 were collected.Patients were divided into HT group and non-HT group based on the postoperative pathological diagnosis.Preoperative thyroid function indexes,serum TgAb and TPOAb,and high-resolution ultrasound(HRUS)findings were compared between groups.Results Among the 98 patients,24 were HT patients either combined malignancies or not,and 74 were non-HT patients.TPOAb and TgAb levels were significantly higher in HT patients than those of non-HT patients(P<0.05).The specificity of a single detection of TPOAb was significantly higher than that of other detections.The coincidence rate of a combination detection of TPOAb+TgAb was the highest.The sensitivity of a combination detection of TPOAb+TgAb combined with HRUS was higher than that of other detections,with the largest area under the curve(AUC)of Receiver Operating Characteristic(ROC)curve.The combination detection of TPOAb+TgAb was highly agreed with postoperative pathology for diagnosing HT(Kappa coefficient=0.687).Conclusion HRUS and detection of serum TPOAb and TgAb have their own advantages in diagnosing HT patients with normal thyroid function.The combination detection of TPOAb plus TgAb has a high accuracy,which is highly agreed with postoperative pathology.The combination detection of TPOAb plus TgAb combined with HRUS exerts the maximum diagnostic efficiency,showing a higher sensitivity for preoperative HT screening.
作者
蒋媛慧
仇美琴
孙莉漪
JIANG Yuanhui;QIU Meiqin;SUN Liyi(Department of Ultrasound,Suzhou Ninth People’s Hospital,Jiangsu,Suzhou 215200,China)
出处
《河北医药》
CAS
2023年第19期2948-2951,共4页
Hebei Medical Journal
关键词
桥本甲状腺炎
甲状腺功能正常
高分辨超声
血清TAPOb
血清TgAb
Hashimoto’s thyroiditis
normal thyroid function
high-resolution ultrasound
serum thyroid peroxidase antibody
serum thyroglobulin antibody
