桥本甲状腺炎患者血清甲状腺过氧化物酶抗体和甲状腺球蛋白抗体表达水平及诊断意义

Expression levels and diagnostic significance of serum TpoAb and TgAb in patients with Hashimoto's thyroiditis

目的探讨桥本甲状腺炎(HT)患者血清甲状腺过氧化物酶抗体(TpoAb)和甲状腺球蛋白抗体(TgAb)表达水平及在诊断和分型中的应用价值。方法选取我院4432例体检人群,采集一般资料并检测血清IgG4、TpoAb和TgAb水平,根据诊断和分型结果对样本进行分组,比较各组检测结果差异,分析血清TpoAb和TgAb水平与IgG4相关性以及对HT诊断和分型的价值。结果HT组血清IgG4、TPOAb和TgAb水平高于对照组,且IgG4-HT组血清IgG4、TPOAb和TgAb水平高于非IgG4-HT组(P<0.05);HT患者血清TPOAb和TgAb水平与IgG4均呈正相关(P<0.05);血清TPOAb、TgAb及两者联合检测诊断HT的AUC分别为0.871、0.839和0.930,灵敏度分别为76.40%、66.29%和85.39%,特异度分别为89.00%、90.00%和90.00%;血清IgG4、TPOAb、TgAb及联合检测对HT进行分型的AUC分别为0.916、0.702、0.777和0.845,灵敏度分别为75.68%、56.76%、64.86%和81.08%,特异度分别为98.08%、80.77%、78.85%和96.15%。结论检测血清TpoAb和TgAb水平对HT早期诊断和分型均具有良好参考价值,有利于HT治疗水平提升和预后改善。

Objective To investigate the expression levels of serum thyroid peroxidase antibody(TpoAb)and thyroglobulin antibody(TgAb)in patients with Hashimoto's thyroiditis(HT)and their application value in the diagnosis and classification of the disease.Methods A cross-sectional study was conducted on 4432 populations with physical examination in our hospital.General data were collected in detail and levels of serum IgG4,TpoAb and TgAb were detected.The samples were grouped based on the diagnosis and classification results.The detected results of each group were compared,and the correlation between serum TpoAb and TgAb levels and IgG4 and their value on HT diagnosis and classification were analyzed.Results The levels of serum IgG4,TPOAb and TgAb in the HT group were higher than those in the control group,and the levels of serum IgG4,TPOAb and TgAb in the IgG4-HT group were higher than those in the non-IgG4-HT group(P<0.05).The levels of serum TPOAb and TgAb in the HT patients were positively correlated with IgG4(P<0.05).By using ROC analysis,the AUCs of serum TPOAb,TgAb and combination of the two in the diagnosis of HT were 0.871,0.839,and 0.930,respectively,and the sensitivities were 76.40%,66.29%and 85.39%,respectively and the specificities were 89.00%,90.00%and 90.00%,respectively.The AUCs of serum IgG4,TPOAb,TgAb and combination of the three in the diagnosis of HT classification were 0.916,0.702,0.777 and 0.845,respectively,and the sensitivities were 75.68%,56.76%,64.86%and 81.08%,respectively and the specificities were 98.08%,80.77%,78.85%and 96.15%,respectively.Conclusion The detection of serum TpoAb and TgAb levels has a good reference value for the early diagnosis and classification of HT.It is beneficial to the improvement of HT treatment and the improvement of prognosis.