【摘要】 比较CLIA和RIA法测定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)的临床应用意义。对经临床诊断甲状腺功能检查及病理证实的 37例慢性淋巴细胞性甲状腺炎患者 ,30例甲亢患者及36例患有内分泌疾病的患者 (包括甲状腺结节、甲状腺癌、糖尿病及库兴氏综合征 )和 35名正常人 ,用CLIA和RIA两种方法分别测定其血清的抗TgAb和抗TpoAb水平 ,并进行比较。结果表明 :(1 )CLIA和RIA法的批内变异分别为 3.0 %和 1 0 .0 % ,批间变异分别为 3.9%和 1 5 .0 % ;(2 )正常人抗TgAb水平分别为CLIA法是 2 5 .9± 9.6U/mL ;RIA为 1 1 .2± 2 .8% ,抗TpoAb水平分别为CLIA法是 31 .4± 6 .7U/mL ;RIA是 8.7± 3.0 % ;(3)慢性淋巴细胞性甲状腺炎患者分别用CLIA法测定抗TaAb为 2 92 .6± 334.1U/mL(1 7例 ) ,RIA为 5 6 .4±1 1 .2 % (2 1例 )。而用CLIA法测定抗TpoAb为 5 0 4 3.3± 31 96 .1U/mL(1 7例 ) ,RIA为 35 .4± 6 .9% (2 1例 ) ,该结果显示CLIA法所测抗TgAb和抗TpoAb水平均明显高于正常人 (P <0 .0 0 1 ) ,特别是抗TpoAb水平比正常人高百倍以上 ,说明其特异性更高 ;(4 )甲亢患者及内分泌病患者 ,用CLIA法测定抗TgAb为 2 0 2 .3±5 0 6 .3U/mL和 2 8.7± 1 5 .0U/mL ;用RIA法为 2 8.8± 2 0 .2 %和 1更多还原

【Abstract】 The serum levels of thyroid globulin auto-antibodies(Anti-TgAb) and thyroid peroxidase auto-antibodies(Anti-TpoAb) in 37 patients with hyperthyroidism, 30 with chronic lymphocytic thyroidism, 36 with other endocrine diseases and 35 healthy persons were determined by chemiluminescence immunoassay(CLIA) and RIA, and the results were compared with each other.The results showed: (1)The within-batch CVs of CLIA and RIA were 3.0% and 10.0%, and the between-batch CVs were 3.9% and 15.0%, respectively; (2)The levels of serum anti-TgAb and Anti-ProAb in healthy people were 25.9±9.6 U/mL and 31.4±6.7U/mL by CLIA, while those were 11.2±2.8% and 8.7±3.0% by RIA; (3)The levels of serum anti-TgAb and Anti-ProAb of chronic lymphocytic thyroidism were 292.6±334.1U/mL and 5043.3±3196.1U/mL(n=17) by CLIA, while those were 56.4±11.2%(n=21) and 8.7±3.0%(n=21) by RIA. It showed that levels of anti-TgAb and Anti-ProAb of chronic lymphocytic thyroidism were much higher than that in healthy people by CLIA( P <0.001).Furthermore, the levels of Anti-ProAb were more than 100 times of that in health people by CLIA and the specificity of Anti-ProAb was higher; (4)The levels of anti-TgAb and Anti-ProAb in hyperthyroid patients were 202.3±506.3U/mL and 452.9±645.8U/mL by CLIA,while those were 28.8±20.0% and 22.6±14.2% by RIA. The levels of Anti-TgAb and Anti-ProAb in patients with other endocrine disease were 28.7±15.0U/mL and 58.8±45.7U/mL by CLIA, while those were 10.2±13.3% and 7.9±7.7% by RIA; (5)These is a significant correlation between the two methods: Anti TgAb r =0.695; and Anti-ProAb r =0.489. This results show that it may be more sensitive and specific test of Anti-ProAb with CLIA than with RIA. CLIA should be used as a powerful diagnostic tool in clinical because it is simple, quick and without radioisotope.更多还原