自身抗体、甲状腺相关抗体检测在干燥综合征合并自身免疫性甲状腺疾病诊断中的应用研究

Application of the autoantibody and thyroid associated antibodies detection in the diagnosis of Sjogren's syndrome combined with autoimmune thyroid disease

目的探讨自身抗体、甲状腺相关抗体指标的检测在SS合并AITD诊断中的应用价值。方法收集SS合并AITD患者108例,其他自身免疫性疾病患者108例和健康体检者50例,对其自身抗体、甲状腺相关抗体等指标进行检测,并进行统计分析。结果 SS合并AITD患者女性发病率高于男性,中年组发病比例最高;抗SSA、抗Ro-52、抗SSB检测阳性率均高于疾病对照组和健康对照组,差异有统计学意义(P<0.05);ANA、抗CENP B和抗AMA-M2阳性率和疾病对照组差异无统计学意义(P>0.05);抗SSA、抗Ro-52、抗SSB并联检测能提高灵敏度,串联检测能提高特异度。青年组甲状腺相关抗体升高较中老年组患者明显,差异有统计学意义(P<0.05),抗SSA、抗Ro-52、抗SSB与TPOAb、TGAb呈正相关(r值分别为0.714、0.698,P<0.05)。结论应联合检测自身抗体、甲状腺相关抗体等指标,为SS合并AITD患者的临床诊断及鉴别诊断提供依据。

Objective To explore the application value of the autoantibody and thyroid associated antibodies detection in the diagnosis of Sjogren＇s syndrome（ SS） combined with autoimmune thyroid disease（ AITD）. Methods 108 cases of patients with SS combined with AITD,108 cases of other autoimmune diseases and 50 cases of healthy control were collected. The immune parameters such as autoantibody,thyroid hormone and their corresponding antibodies were detected and analyzed by statistical analysis. Results The incidence rate of female in SS combined with AITD patients was higher than that in male,and the highest incidence rate was in middle age group. The positive rates of anti SSA,anti- ro- 52 and anti SSB in SS combined with AITD patients were higher than those in disease control group and healthy control group,and the differences were statistically significant（ P〈0. 05）; although the positive rates of ANA,anti CENP B and anti AMA- M2 were higher than disease control group,the differences were not statistically significant（ P〉0. 05）; the combined detection of anti SSA,anti- ro- 52,anti SSB can improve the sensitivity,while,the parallel detection can improve the detection specificity. The thyroid associated antibodies in the youth group were significantly higher than that in the elderly group,the difference was statistically significant（ P〈0. 05）.Anti SSA,anti Ro- 52,anti SSB and TPOAb,TGAb were positively correlated（ r = 0. 714,0. 698,P〈0. 05）. Conclusion Combined detection of autoantibodies,thyroid associated antibodies and other indicators should be conducted,so as to provide basis for clinical diagnosis and identificational diagnosis of SS patients with AITD.