【摘要】 目的分析自身免疫性甲状腺炎(AIT)患者血清促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPOAb)以及甲状腺球蛋白抗体(TGAb)与甲状腺细针抽吸(FNAB)细胞病理学改变之间的关系。方法选取经甲状腺细胞病理学诊断的82例AIT患者,采集空腹静脉血分别进行TSH、TPOAb、TGAb及T4等检测,分析血清学指标与细胞病理学改变的相关性。结果①82例患者中TPOAb、TGAb的阳性率分别为91.4%和74.4%,约有半数(47.6%)TSH值位于正常值范围内(0.3~5 mu/L);②所有患者细胞病理学均存在淋巴细胞不同程度的浸润,49.3%可见生发中心,32.8%可见嗜酸性变细胞(Askanazy细胞),26.9%可见浆细胞,22.4%可见胶质,9%可见多核巨细胞;③将淋巴细胞浸润程度分级,分别与TSH、TPOAb及TGAb进行相关性分析,发现仅淋巴细胞极重度浸润者其血清TSH、TPOAb水平较其他组显著升高(P<0.05),其他细胞病理学改变与血清学指标之间未发现显著相关性。结论TPOAb、TGAb是AIT诊断的重要指标。更多还原

【Abstract】 Objective To analyze the relationship of serum levels of TSH,thyroid peroxidase antibody(TPOAb) and thyroglobulin antibody(TGAb) with cytopathologic changes of thyroid fine needle aspiration(FNAB) in autoimmune thyroiditis(AIT).Methods Totally 82 cases of cytologically confirmed AIT including 75 females and 7 males were collected.Levels of TSH,TPOAb and TGAb were tested.After execution of FNAB,features of the cytopathology were observed.Results ① The percentage of positive TPOAb and TGAb were 91.4% and 74.4%,respectively in all the AIT patients.47.6% of the patients had TSH levels within normal range(0.3～5 mu/L).② All of the slides had different grades of lymphocytic infiltration.49.3% had germinal center,32.8% had Askanazy cells,26.9% had plasma cells,22.4% had colloid,and 9% had multinuclear giant cells.③ Lymphocytic infiltration was divided into four degrees.The levels of TSH and TPOAb increased significantly in the extremely heavy lymphocytic infiltration grade than in the others(P<0.05).There was no relationship between serologic markers and other cytopathologic features.Conclusion TPOAb and TGAb are important markers for the diagnosis of AIT.更多还原