摘要
目的 运用ROC曲线评价促甲状腺激素受体抗体（TRAb）在诊断毒性弥漫性甲状腺肿（Graves）病中的应用价值.方法 参照〈内科学〉（第7版）,根据Graves病的诊断标准,结合病史及甲状腺激素水平,选取甲状腺功能紊乱患者41例,分为两组：Graves病组25例,非Graves病组16例;另设健康对照组40名.采用化学发光法对三组人群血清中的TRAb进行定量检测.比较三组结果间的差异,评估Graves病的诊断临界值及建立健康人群的参考范围.结果 Graves病组TRAb结果为118.07（43.84-371.27）IU/ml,高于非Graves病组的33.76（20.54-95.45）IU/ml和健康对照组的33.13（11.16~49.94）IU/ml,差异有统计学意义（H=47.35,P＜0.01）;而非Graves病组和健康对照组之间比较差异无统计学意义（Z=-1.215,P＞0.05）.对实验数据进行ROC曲线分析显示,TRAb 诊断Graves病的ROC曲线下面积（AUC）为0.974（95%CI 0.946~1.000）,诊断临界值为50.29 IU/ml,其诊断敏感度为96.00%（95%CI 80.00%~100.00%）,诊断特异度为91.10%（95%CI 83.64%~98.55%）,阳性预期值为82.75%,阴性预期值为98.07%,正确率为92.59%,Youden值为87.10%.该实验室健康人群的参考范围为0.00~45.44 IU/ml.结论 TRAb在诊断Graves病中具有较高的敏感度和特异度,可作为Graves病诊断以及与其他甲状腺功能紊乱的鉴别诊断指标.
Objective To evaluate the diagnostic value of TSH receptor antibody（TRAb） in Graves disease by ROC analysis. Methods According to ＂Internal medicine＂ （seventh Edition） and the diagnostic criteria of Graves disease,patients＇ medical history and level of thyroidhormone,selected 41 patients with functional disorder of thyroid and divided them into two groups： 25 patients with Graves disease and 16 patients without Graves disease. Meanwhile, 40 healthy individuals were selected as a control group. TRA was detected by chemiluminescence immunoassay. The difference of results of three groups were compared. The critical value of diagnosis of Graves disease was evaluated and the reference rang of healthy people was established. Results The result,： of TRAb in Graves group [118.07（43.84-371.27）IU/ml] were higher than those of non-Graves disease group[33.76（20.54-95.45）IU/ml] and control group[33.13（11.16-49.94）IU/ ml]. There was statistically significant difference （H= 47.35, P〈0. 01）. However,there was no difference between non- Graves disease group and control group. ROC curve analysis showed that the area under curve was 0. 974（95}/00CI 0. 946- 1. 000）,the critical value of diagnosis was 50. 29 IU/ml ,the sensitivity ,specificity ,predicted value of positive ,predicted value of negtive,correct rate and value Youden were 96.00% ,91.10%,82.75%,98. 07%,92.59% and 87.10% respectively. The reference rang of healthy people of laboratory was 0.00-4g. 44IU/ml. Conclusion TRAb could he used as indicators for diagnosis Graves disease for its high sensitivity and specificity.
出处
《现代检验医学杂志》
CAS
2011年第5期100-101,104,共3页
Journal of Modern Laboratory Medicine
