血清甲状腺过氧化物酶抗体对Graves病合并桥本甲状腺炎的诊断意义

The diagnositic significance of serum thyroid peroxidase antibody in patients with Graves disease and Hashimoto's thyroiditis

目的探讨血清甲状腺过氧化物酶抗体(TPOAb)对Graves病(GD)、Graves病合并桥本甲状腺炎(GH)诊断的临床意义。方法选取2008年1月—2014年12月天津医科大学总医院外科临床确诊为GD、并经手术治疗的患者58例,术后依据甲状腺病理结果分为GD组39例和GH组19例。比较2组血清TPOAb水平及甲状腺内淋巴细胞浸润程度。结果 GD组术前血清TPOAb水平明显低于GH组[60.0(15.0,317.0)IU/m L vs.800.0(231.6,1 000.0)IU/m L,P<0.01];甲状腺淋巴细胞浸润程度明显低于GH组(Z=4.334,P<0.01)。结论 GH患者相比于单纯GD患者血清TPOAb水平更高、甲状腺内淋巴细胞浸润程度更重。

Objective To study the clinical significance of the serum thyroid peroxidase antibody(TPOAb) for thediagnosis of Graves disease(GD) and Graves with combined Hashimoto thyroiditis(GH). Methods Fifty-eight in-patientswho were diagnosed as GD and underwent thyroidectomy in the Department of General Surgery at Tianjin Medical UniversityGeneral Hospital between January 2008 and December 2014 were enrolled in this study. Patients were divided into GDgroup(n=39) and GH group(n=19) according to the postoperative pathological results of the thyroid gland. The serumTPOAb titer and the degree of thyroid lymphocytic infiltration were compared between two groups. Results Thepreoperative serum TPOAb titer was obviously lower in GD group than that in GH group [60.0(15.0,317.0) IU/m L vs. 800.0(231.6, 1000.0) IU/m L, P<0.01]. The degree of thyroid lymphocytic infiltration was obviously lower in GD group than that ofGH group(Z=4.334, P<0.01). Conclusion The serum TPOAb titer and the degree of thyroid lymphocytic infiltration arehigher in GH patients than those in patients with GD alone.