【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。更多还原

【Abstract】 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 Gravesdisease, 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, Hashimotos 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.更多还原