标题：Anti-TPO、Anti-TG及TRAb在桥本甲状腺诊断中的应用

      作者：吴菊，周梅，吕雅妮，郭清萍    榆林市中医医院检验科，陕西 榆林 719000

      卷次： 2023年34卷5期

      【摘要】 目的 探究抗甲状腺过氧化物酶抗体(Anti-TPO)、抗甲状腺球蛋白抗体(Anti-TG)及促甲状腺激素受体抗体(TRAb)在桥本甲状腺诊断中的应用价值及临床意义。方法 回顾性分析2019年10月至2021年10月榆林市中医医院收治的124例自身免疫性甲状腺疾病患者的临床资料。根据患者确诊结果分为桥本甲状腺组(n=59)和非桥本甲状腺组(n=65)，比较两组患者的血清Anti-TPO、Anti-TG、TRAb水平，使用受试者特征(ROC)分析患者血清Anti-TPO、Anti-TG、TRAb水平对桥本甲状腺的诊断效能。将桥本甲状腺组患者根据甲状腺功能水平分为低下组(n=21)、正常组(n=18)和亢进组(n=20)，比较不同甲状腺功能水平患者的血清Anti-TPO、Anti-TG、TRAb水平，使用Spearman法分析桥本甲状腺患者血清Anti-TPO、Anti-TG、TRAb水平与甲状腺功能的相关性。结果 桥本甲状腺组患者的血清Anti-TPO、Anti-TG水平分别为(505.11±107.89) U/mL、(142.58±51.54) U/mL，明显高于非桥本甲状腺组的(236.96±79.89) U/mL、(73.20±28.92) U/mL，血清TRAb水平为(3.38±1.31) U/mL明显低于非桥本甲状腺组的(17.56±8.65) U/mL，差异均有统计学意义(P<0.05)；经ROC分析结果显示，血清Anti-TPO、Anti-TG、TRAb对桥本甲状腺的诊断效能均较高(AUC=0.972、0.884、0.966，P<0.05)；低下组患者血清的Anti-TPO为(590.79±81.22) U/mL，明显高于正常组的(458.90±78.66) U/mL和亢进组的(456.73±102.24) U/mL，差异均具有统计学意义(P<0.05)，而亢进组患者血清的Anti-TG水平为(178.18±46.40) U/mL，明显高于低下组的(126.96±43.78) U/mL和正常组的(121.26±46.13) U/mL，差异均具有统计学意义(P<0.05)，但正常组和亢进组患者的血清Anti-TPO比较，低下组和正常组患者的血清Anti-TG比较，以及三组患者的血清TRAb比较差异均无统计学意义(P>0.05)；经Spearman分析结果显示，桥本甲状腺患者血清Anti-TPO、Anti-TG水平均与患者甲状腺功能相关(r=-0.526、0.414，P<0.05)。结论 血清Anti-TPO、Anti-TG、TRAb具备诊断桥本甲状腺的价值，且桥本甲状腺患者的甲状腺功能与血清Anti-TPO、Anti-TG水平具有相关性。
      【关键词】 甲状腺疾病；桥本甲状腺；抗甲状腺过氧化物酶抗体；抗甲状腺球蛋白抗体；促甲状腺激素受体抗体；诊断；相关性
      【中图分类号】 R581 【文献标识码】 A 【文章编号】 1003—6350（2023）05—0684—04

Application value of Anti-TPO, Anti-TG, and TRAb in the diagnosis of Hashimoto's thyroditis.
WU Ju, ZHOUMei, LV Ya-ni, GUO Qing-ping. Department of Laboratory Medicine, Yulin Hospital of Traditional Chinese Medicine, Yulin719000, Shaanxi, CHINA
【Abstract】 Objective To explore the application value and clinical significance of anti-thyroid peroxidase anti-body (Anti-TPO), anti-thyroglobulin antibody (Anti-TG), and thyrotrophin receptor antibody (TRAb) in the diagnosis ofHashimoto's thyroditis. Methods The clinical data of 124 patients with autoimmune thyroid diseases treated in YulinHospital of Traditional Chinese Medicine between October 2019 and October 2021 were retrospectively analyzed. Ac-cording to the diagnosis results, the patients were divided into Hashimoto's thyroditis group (n=59) and non-Hashimoto'sthyroditis group (n=65). The differences in serum Anti-TPO, Anti-TG, and TRAb levels were compared between the twogroups. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficiency of serum Anti-TPO,Anti-TG and TRAb levels on Hashimoto's thyroditis. The patients in Hashimoto's thyroditis group were classified intohypo group (n=21), normal group (n=18), and hyper group (n=20) according to the level of thyroid function. The differ-ences in the levels of serum Anti-TPO, Anti-TG, and TRAb were compared among patients with different thyroid func-tion levels. Spearman method was used to analyze the correlation between serum Anti-TPO, Anti-TG and TRAb levelsand thyroid function in patients with Hashimoto's thyroditis. Results The levels of serum Anti-TPO and Anti-TG were(505.11±107.89) U/mL and (142.58±51.54) U/mL in Hashimoto's thyroditis group, significantly higher than (236.96±79.89) U/mL and (73.20±28.92) U/mL in non-Hashimoto's thyroditis group, while the level of serum TRAb was (3.38±1.31) U/mL, significantly lower than (17.56±8.65) U/mL in non-Hashimoto's thyroditis group (P<0.05). ROC curve anal-ysis results showed that serum Anti-TPO, Anti-TG, and TRAb had high diagnostic efficiency on Hashimoto's thyroditis(AUC=0.972, 0.884, 0.966, P<0.05). Serum Anti-TPO was (590.79±81.22) U/mL in hypo group, significantly higherthan (458.90±78.66) U/mL in normal group and (456.73±102.24) U/mL in hyper group (P<0.05); serum Anti-TG levelwas (178.18±46.40) U/ mL in hyper group, significantly higher than (126.96±43.78) U/mL in hypo group and (121.26±46.13) U/mL in normal group (P<0.05); there were no statistically significant differences in serum Anti-TPO betweennormal group and hyper group, in serum Anti-TG between hypo group and normal group, and in serum TRAb among thethree groups (P>0.05). Spearman analysis showed that serum levels of Anti-TPO and Anti-TG in patients with Hashimo-to's thyroid were correlated with thyroid function (r=-0.526, 0.414, P<0.05). Conclusion Serum Anti-TPO, Anti-TG,and TRAb have value in the diagnosis of Hashimoto's thyroditis, and thyroid function of patients with Hashimoto’s thy-roditis is correlated with the levels of serumAnti-TPO and Anti-TG.
      【Key words】 Thyroid disease; Hashimoto's thyroditis; Anti-thyroid peroxidase antibody; Anti-thyroglobulin anti-body; Thyrotropin receptor antibody; Diagnosis; Correlation