Bednár J
Endokrinologický ústav, Praha.
Vnitr Lek. 1992 Sep;38(9):887-96.
The author presents a brief account of the clinically most important antibodies against thyroid antigens (against thyroglobulin, against the microsomal fraction or thyroid peroxidase, against thyroid hormones and against TSH receptors). He describes the main ways of their assessment in serum and evaluates the practical contribution of their estimation or detection in clinical diagnostic practice concerning endocrinopathies. Usually these estimations are only auxiliary and do not replace functional thyroid tests. Antibodies against thyroglobulin and against the microsomal fraction are found most frequently (and in the highest concentrations) in thyropathies with an assumed autoimmune component, in particular in lymphocytic thyroiditis. The low specificity (they are as a rule present also in other thyroid diseases and also in clinically eufunctional subjects with and without goitre) due to the relatively low prevalence reduce the diagnostic value of the examination. The examination of antireceptor antibodies is important, in particular in the diagnosis of immunogenic hyperthyroidism. The prevalence of antibodies against thyroid hormones is low and their detection serves about all to elucidate cases where the patient's clinical status is not in agreement with assessment of thyroid hormones.
作者简要介绍了临床上针对甲状腺抗原(抗甲状腺球蛋白、抗微粒体部分或甲状腺过氧化物酶、抗甲状腺激素以及抗促甲状腺激素受体)的最重要抗体。他描述了在血清中评估这些抗体的主要方法,并评估了在临床诊断实践中对其进行测定或检测对内分泌疾病的实际贡献。通常这些测定仅起辅助作用,不能替代甲状腺功能测试。抗甲状腺球蛋白抗体和抗微粒体部分抗体在假定有自身免疫成分的甲状腺疾病中最为常见(且浓度最高),尤其是在淋巴细胞性甲状腺炎中。由于相对较低的患病率导致特异性较低(通常在其他甲状腺疾病以及有或无甲状腺肿的临床甲状腺功能正常的受试者中也存在),这降低了该项检查的诊断价值。抗受体抗体的检测很重要,特别是在免疫性甲状腺功能亢进的诊断中。抗甲状腺激素抗体的患病率较低,其检测主要用于阐明患者临床状况与甲状腺激素评估不一致的情况。