甲状腺自身抗体的两种方法检测结果的比较及临床价值的探讨

Methodological Comparison of Thyroid Autoantibodies Measurement and its Relation to Clinical Significance

目的 对比两种方法检测甲状腺球蛋白抗体 (TGA)、甲状腺微粒体抗体 (TMA)、甲状腺过氧化酶抗体(TPoA)结果及其临床价值 .方法 对 7例桥本氏病 (HD)和甲状腺功能亢进 4 0例 ,采用RIA法检测TGA、TMA及CLIA法测定其TGA、TPoA的水平 .结果 HD患者RIA法检测TGA、TMA和CLIA法检测TGA、TPoA均高于正常水平 ,2 1例甲亢患者两种方法的检测结果均有 1项以上增高 ;7例CLIA法检测TGA、TPoA有 1项以上增高 ,但RIA法检测TGA、TMA均为阴性 ;其余 11例两种方法测定结果均为正常水平 .相关系数比较 :方法内TGA和TMAr=0 .94 (RIA法 ) ,TGA和TPoAr=0 .15 (CLIA法 ) ;RIA法和CLIA法TGAr=0 .5 5 ,TMA和TPoAr=0 .6 3.结论 ①对于HD ,TGA和TMA或TGA和TPoA的同时检测 ;②对于甲亢CLIA法检测TGA和TPoA的阳性率明显优于RIA法检测TGA和TMA .

Objective To investigate the clinical significant in thyroid autoantibodies results measured by two different methodologies-che miluminescence immunoassay (CLIA) and radio immunoassay (RIA). Methods Serums from patients confirmed as Hashimoto's disease (n=7) and hyperthyroidism ( n=40) were tested for thyroglobulin antibody (TGA), thyroid microsomal antibody (TMA) by RIA and tested for TGA, thyriod peroxidase antibody (TPoA) by CLIA. Results All Hashimoto's disease patients had positive /increase level of the three antibodies measured by both methods. 21 cases of hyperthyroidism had increased level of either TGA or TPoA measured by CLIA and increased level of either TGA or TMA measured by RIA. 7 cases that had increased level of either TGA or TPoA measured by CLIA appeared to have negative results when measured by RIA. The other 11 cases showed negative results by both methods.Correlation(γ)analysis showed that correlation between TGA and TMA was:γ=0.94(RIA);between TGA and TPoA was:γ=0.15 (RIA).Between two methods was γ=0.55 for TGA, while γ=0.63 between TMA and TPoA. Conclusions For Hashimoto's disease patients, there is no differences in term of clinical significance on using either method for the autoantibodies measurement. For hyperthyroidism, CLIA measurement of autoantibodies had advantage over RIA in term of higher sensitivity.