甲状腺自身抗体对桥本氏甲状腺炎诊断价值的Meta分析

Diagnostic value of thyroid autoantibodies in Hashimoto′s thyroiditis:a Meta analysis

目的系统评价甲状腺自身抗体的表达对桥本氏甲状腺炎的诊断价值。方法通过对中国期刊全文数据库(CNKI)、中国科技期刊全文数据库(VIP)、万方数据库、PubMed、EMbase、Scopus、Cochrane图书馆,以及国内外的学位论文数据库、会议论文数据库等进行系统检索,检索起止时间为建库至2017年1月所有正式发表的科研文献。检索条件为在期刊数据库的主题中检索包括"甲状腺自身抗体"、"甲状腺过氧化物酶抗体"或"TPOAb"、"甲状腺球蛋白抗体"或"TGAb"、"甲状腺微粒体抗体"或"TMAb"、"促甲状腺激素受体抗体"或"TRAb"、"桥本氏甲状腺炎"或"桥本氏病"。在符合标准的研究中,对几种甲状腺自身抗体、桥本氏甲状腺炎等各方面数据进行Meta分析,找出最佳临床证据。结果对纳入的33篇文献进行Meta分析,桥本氏甲状腺炎组患者甲状腺过氧化物酶抗体(TPOAb)、抗甲状腺球蛋白抗体(TGAb)、促甲状腺素受体抗体(TRAb)水平较健康对照组明显升高,桥本氏甲状腺炎组患者TPOAb、TGAb、TRAb、TMAb阳性率显著高于健康对照组,差异有统计学意义(P<0.05)。结论甲状腺自身抗体TPOAb、TGAb、TRAb、TMAb的检测对桥本氏甲状腺炎的诊断有重要的临床价值。

Objective To systematically evaluate the diagnosis value of thyroid autoantibodies in hashimoto′s thyroiditis.Methods Through the systematic retrieval of the Chinese periodical full text database（CNKI）,the full text database of Chinese sci-tech periodicals（VIP）,the Wanfang database,the PubMed,EMbase,Scopus,Cochrane library,the database of academic dissertations at home and abroad,the database of the conference papers and so on,all formally published scientific research literature from the establishment of database to January 2017 were retrieved.The retrieval conditions included ＂thyroid autoantibody＂, ＂thyroid peroxidase antibody＂ or ＂ TPOAb＂, ＂thyroid globulin antibody＂ or ＂ TGAb＂, ＂thyroid microsome antibody＂ or ＂TMAb＂, ＂thyrotropin receptor antibody＂ or ＂ TRAb＂, ＂ Hashimoto＂ ＂ Mastitis＂ or ＂ Hashimoto′s disease＂.The study that accorded with the standard,the data of thyroid autoantibodies,Hashimoto′s thyroiditis and other data were analyzed by Meta in order to find out the best clinical evidence.Results In the meta-analysis of 33 articles,the levels of thyroid peroxidase antibody（TPOAb）,antithyroid globulin antibody（TGAb）and thyrotropin receptor antibody（TRAb）in the patients with Hashimoto′s thyroiditis were significantly higher than those in the healthy control group.The positive rates of TPOAb,TGAb,TRAb and TMAb in the patients with Hashimoto′s thyroiditis group were higher than those in the healthy control group.The difference was statistically significant（P0.05）.Conclusion Detection of thyroid autoantibodies TPOAb,TGAb,TRAb and TMAb has important clinical value in the diagnosis of Hashimoto′s thyroiditis.