摘要
目的 探讨促甲状腺激素(TSH)、抗甲状腺过氧化物酶抗体(TPOAb)、抗甲状腺球蛋白抗体(TGAb)联合检测对自身免疫性甲状腺疾病(AITD)的诊断价值.方法 选取2022年8月至2023年7月郑州四六○医院收治的96例AITD患者作为AITD组,另选取同期接受体检的45名健康者作为对照组,均接受TSH、TPOAb、TGAb检测.比较2组、不同类型AITD患者上述指标水平,进行单因素与多因素logistic回归分析,采用受试者工作特征(ROC)曲线评估诊断价值.结果 AITD组TSH、TPOAb、TGAb水平较对照组更高(P＜0.05);96例AITD患者中,原发性甲状腺功能减退(SCH)26例、桥本甲状腺炎(HT)32例、格雷夫斯病(GD)38例;在TSH水平上,SCH患者较HT、GD患者更高(P＜0.05),HT患者较GD患者更高(P＜0.05);在TPOAb、TGAb水平上,SCH患者较HT患者更高(P＜0.05),SCH、HT与GD患者比较差异无统计学意义(P＞0.05);多因素 logistic 分析结果显示,TSH[OR(95％CI)=2.369(1.295,3.417)]、TPOAb[(OR(95％CI)=3.175(1.603,4.922)]、TGAb[(OR(95％CI)=3.218(1.337,5.006)]是影响AITD发生的独立危险因素(P＜0.05);绘制ROC曲线显示,TSH、TPOAb、TGAb、TSH+TPOAb、TSH+TGAb、TPOAb+TGAb、联合检测诊断 AITD 的曲线下面积(AUC)分别为0.819、0.832、0.862、0.908、0.909、0.886、0.950.结论 TSH、TPOAb、TGAb 与 AITD 之间存在密切关系,且不同类型AITD患者有所差异,上述指标可作为诊断AITD的重要依据,联合检测时具有更高的诊断价值.
Abstract
Objective To explore the diagnostic value of combined detection of thyroid stimulating hor-mone(TSH),anti-thyroid peroxidase antibody(TPOAb)and anti-thyroglobulin antibody(TGAb)in autoimmune thyroid disease(AITD).Methods Ninety-six AITD patients from August 2022 to July 2023 who were admitted in Zhengzhou 460 hospital were selected as the AITD group,and 45 healthy individuals who were underwent physical examinations during the same period were selected as the control group.All subjects underwent TSH,TPOAb,and TGAb tests.The above indicators levels were compared in both groups and different types.Univariate and multi-variate logistic regression analysis was performed.The diagnostic value was evaluated by receiver operating charac-teristic(ROC)curves.Results In the TSH,TPOAb,and TGAb levels,in comparison of the control group,the AITD group was higher(P＜0.05).Among 96 AITD patients,there were 26 cases of subclinical hypothyroidism(SCH),32 cases of Hashimoto's thyroiditis(HT),and 38 cases of toxic diffuse goiter(GD).In TSH level,in com-parison of HT and GD patients,SCH patients were higher(P＜0.05),in comparison of GD patients,HT patients were higher(P＜0.05).In the TPOAb and TGAb levels,there was no statistically significant difference in SCH and HT,compared with GD patients(P＞0.05).The results of multivariate logistic analysis showed that TSH OR[(95％CI)=2.369(1.295,3.417)],TPOAb[OR(95％CI)=3.175(1.603,4.922)],and TGAb[(OR(95％CI)=3.218(1.337,5.006)]were independent risk factors affecting AITD(P＜0.05).ROC curves showed that the area under the curve(AUC)for TSH,TPOAb,TGAb,TSH+TPOAb,TSH+TGAb,TPOAb+TGAb,and combined detection for diagnosing AITD were 0.819,0.832,0.862,0.908,0.909,0.886,and 0.950,respectively.Conclusion There is a close rela-tionship between TSH,TPOAb,TGAb and AITD,and there are differences among patients with different types of AITD.The above indicators can serve as important criteria for diagnosing AITD,and joint testing has higher diag-nostic value.
NETL
NSTL
万方数据