A-TSHR、TPOAb测定在自身免疫性甲状腺疾病诊断中的应用魏忠华何思春王利君(四川省达州市屮心医院检验科635000)摘要：目的探讨促甲状腺受体抗体(A-TSHR)和甲状腺过氧化物酶抗体(TPO-Ab)测定在自身免疫性甲状腺疾病(AITD)屮诊断和治疗的价值。方法将280例AITD患者分为3组：甲亢组、甲减组、桥本氏甲状腺炎组(桥本组)及健康体检对照组80人，用电化学发光法检测各组屮FT3、FT4、TSH、A-TSHR、TPO-Ab的含量，并对各组A-TSHR、TPO-Ab的浓度及阳性率进行比较。结果甲亢组屮的FT3、FT4明显高于甲减组、桥本组及对照组(P<0.005),甲减组明显低于其它各组(P<0.005),桥本组略低于对照组，但差异无显著性(P〉0.05);甲亢组中的TSH明显低于其它各组(P<0.005),甲减组明显高于其它各组(P<0.005),桥本组略高于对照组，但差异无显著性(P>0.05)；甲亢组屮的A-TSHR(浓度和阳性率)明显高于甲减组、桥本组及对照组(P<0.005),甲减组、桥本组均高于对照组(P<0.005)，但甲减组与桥本组差异无显著性(P>0.05)；甲亢组屮的TPO-Ab(浓度和阳性率)高于甲减组和对照组(P<0.005),低于桥本组(P<0.005),甲减组高于对照组(P<0.005)；结论在自身免疫性甲状腺疾病(AITD)患者屮联合检测FT3、FT4、TSH、A-TSHR和TPO-Ab对甲亢、甲减、桥本氏甲状腺炎的诊断和鉴别诊断有重要意义，对它们的疗效观察及预后判断也有较大的临床价值。关键词:A-TSHR;TPOAb；自身免疫性甲状腺疾病；诊断【屮图分类号】R2【文献标号】A【文章编号】2095-7165(2015)15-0002-02ApplicationofA-TSHR、TPOAbdetectionindiagnosisofautoimmunethyroiddiseaseWeizhong-huaHesi-chunWangli-junThecentralhospitalofDazhoucity,Sichuan,china.635000Abstract:ObjectiveToexplorethevalueofdiagnosisandtreatmentofThyroidstimulatingreceptorantibody(A-TSHR)andthyroidperoxidaseantibody(TPO-Ab)inautoimmunethyroiddisease(AITD).Method280AITDpatientsweredividedinto3groups:Gravesdiseasegroup,hypothyroidismgroup,hashimoto’sthyroiditisgroup(hashimotogroup)andthecontrolgroup(80cases).FT3,FT4,TSH,A-TSHRandTPO-Ablevelsweredetectedbyelectrochemiluminescenceimmunoassayineachgroup,andcomparedA-TSHR,TPO-Ablevelsandpositiveratewitheachother.ResultsTheserumFT3,FT4levelsinhyperthyroidismgroupwasobviouslyhigherthanthoseinhypothyroidismgroup,hashimotogroupandthecontrolgroup(P<0.005),hypothyroidismgroupwaslowerthanothergroups(P<0.005),hashimotogroupisslightlylowerthanthecontrolgroup,buttherewasnosignificantdifference(P>0.05);TheserumTSHlevelsinhyperthyroidismgroupwasobviouslylowerthanothergroups(P<0.005),hypothyroidismgroupissignificantlyhigherthanothergroups(P<0.005),hashimotogroupisslightlyhigherthanthecontrolgroup,buttherewasnosignificantdifference(P>0.05);TheserumA-TSHR(levelsandpositiverate)inhyperthyroidismgroupwassignificantlyhigherthanthoseinhypothyroidismgroup,hashimotogroupandthecontrolgroup(P<0.005),hypothyroidismgroupandhashimotogroupwerehigherthancontrolgroup(P<0.005),buttherewasnosignificantdifferencehypothyroidismgroupwithhashimotogroup(P>0.05);TheserumTPO-Ab(levelsandpositiverate)inhyperthyroidismgroupwassignificantlyhigherthanhypothyroidismgroupandthecontrolgroup(P<0.005),butitwaslowerthanthatofhashimotogroup(P<0.005),hypothyroidismgroupishigherthanthecontrolgroup(P<0.005);ConclusioncombineddetectionofFT3,FT4,TSH,A-TSHRandTPO-Abinautoimmunethyroiddisease(AITD)haveanimportantclinicalsignificanceindiagnosisanddifferentialdiagnosisforhyperthyroidism,hypothyroidism,hashimoto’sthyroiditis,andalsohasbetterclinicalvaluefortheestimationofcurativeeffectandprognosisinautoimmunethyroiddisease.Keyword:A-TSHR；TPOAb;autoimmunethyroiddisease;diagnosis自身免疫性甲状腺疾病（AITD）包括Grave...
