上海地区6 112例健康体检者血清甲状腺激素和甲状腺自身抗体检测结果分析

doi:10.3969/j.issn.1673-8640.2015.03.003

摘要/Abstract

摘要： 目的

调查上海地区体检人群甲状腺功能异常的情况以及在健康体检中的必要性。

方法

选择 6 112 名进行健康体检并接受甲状腺功能检测的上海地区人员。受检人员清晨空腹取静脉血,使用西门子ADVIA CENTAUR XP全自动化学发光免疫分析仪检测血清三碘甲状原氨酸(T3)、甲状腺素(T4)、游离三碘甲状原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、甲状腺球蛋白抗体(TGAb)和甲状腺过氧化物酶抗体(TPOAb),对检测结果进行统计学分析。

结果

在6 112名受检者中,甲状腺功能亢进(甲亢)、甲状腺功能减退(甲减)、亚临床甲亢及亚临床甲减的检出率分别为0.47、0.34、0.62 及2.55,甲状腺疾病女性发病率高于男性(P=0.001)。女性受检者血清甲状腺激素或自身抗体异常率也显著高于男性受检者(P=0.001)。10.37%的受检者血清甲状腺激素正常,但甲状腺自身抗体水平升高。随着年龄的增长,甲状腺疾病的发病率和血清甲状腺激素或自身抗体异常率均呈明显增高趋势。

结论

上海地区甲状腺功能紊乱以甲减和亚临床甲减为主,女性发病率高于男性,且与年龄相关。在健康体检中加入甲状腺功能及相关自身抗体检查是非常必要和有价值的。

关键词: 甲状腺激素, 甲状腺自身抗体, 健康体检

Abstract: Objective

To investigate the situation of thyroid dysfunction among physical examination subjects in Shanghai, and analyze the necessity of thyroid function test in healthy physical examination.

Methods

A total of 6 112 subjects in Shanghai undergoing healthy physical examination, including serum thyroid hormone and thyroid autoantibody determinations, were enrolled. Their fasting venous blood samples were collected at early morning. Serum triiodothyronine(T3),thyroxin(T4),free triiodothyonine(FT3),free thyroxin(FT4),thyroid stimulating hormone(TSH),anti-thyroglobulin antibody(TGAb) and thyroid peroxidase antibody(TPOAb) were detected by SIEMENS ADVIA CENTAUR XP automatic chemiluminescence analyzer. The results were analyzed statistically.

Results

Among the 6 112 subjects, the detection rates of hyperthyroidism, hypothyroidism, subclinical hyperthyroidism and subclinical hypothyroidism were 0.47, 0.34, 0.62 and 2.55, respectively. Female incidence rates of hyperthyroidism, hypothyroidism, subclinical hyerthyroidism and subclinical hypothyroidism were higher than those in males(P=0.001). Female abnormal rates of serum thyroid hormone and thyroid autoantibodies were significantly higher than those in males(P=0.001). Serum thyroid hormone in 10.37% of the subjects was normal, however, with the increasing levels of thyroid autoantibodies. With the increasing of age, the incidence rate of thyroid dysfunction and the abnormal rates of serum thyroid hormone and thyroid autoantibodies showed a trend of increase.

Conclusions

Hypothyroidism and subclinical hypothyroidism are major thyroid dysfunctions in Shanghai, with higher female incidence and abnormal rates than male's, and there is a relationship with age. The determinations of thyroid hormone and thyroid autoantibodies in healthy physical examination are very necessary and valuable.

Key words: Thyroid hormone, Thyroid autoantibody, Healthy physical examination

中图分类号:

R446.11

袁帅, 江璐, 朱力, 卢龙坤, 马金龙, 吴豫. 上海地区6 112例健康体检者血清甲状腺激素和甲状腺自身抗体检测结果分析[J]. 检验医学, 2015, 30(3): 219-223.

YUAN Shuai, JIANG Lu, ZHU Li, LU Longkun, MA Jinlong, WU Yu. Investigation on the results of thyroid hormone and thyroid autoantibody determinations in 6 112 healthy subjects in Shanghai[J]. Laboratory Medicine, 2015, 30(3): 219-223.

图/表 5

参考文献 15

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组别	男性	女性	男女比例
甲亢	10(0.99)	19(1.88)	1∶1.90
亚临床甲亢	17(1.68)	21(2.08)	1∶1.24
甲减	7(0.69)	14(1.39)	1∶2.00
亚临床甲减	63(6.24)	93(9.22)	1∶1.48
单纯TPOAb阳性	116(11.50)	96(9.51)	1∶0.82
单纯TGAb阳性	45(4.46)	123(12.19)	1∶2.73
TPOAb和TGAb均阳性	65(6.44)	189(18.73)	1∶2.91
其它^☆	82(8.13)	49(4.86)	1∶0.60
合计	405(40.14)	604(59.86)	1∶1.49

组别	男性	女性	男女比例
甲亢	10(0.99)	19(1.88)	1∶1.90
亚临床甲亢	17(1.68)	21(2.08)	1∶1.24
甲减	7(0.69)	14(1.39)	1∶2.00
亚临床甲减	63(6.24)	93(9.22)	1∶1.48
单纯TPOAb阳性	116(11.50)	96(9.51)	1∶0.82
单纯TGAb阳性	45(4.46)	123(12.19)	1∶2.73
TPOAb和TGAb均阳性	65(6.44)	189(18.73)	1∶2.91
其它^☆	82(8.13)	49(4.86)	1∶0.60
合计	405(40.14)	604(59.86)	1∶1.49

组别	例数	自身抗体			阳性率 (%)
组别	例数	TGAb 阳性	TPOAb 阳性	TPOAb和 TGAb均阳性	阳性率 (%)
甲亢	29	4	8	10	75.86
亚临床甲亢	38	5	2	7	36.84
甲减	21	2	1	10	61.90
亚临床甲减	156	8	13	50	45.51
合计	244	19	24	77	49.18

组别	例数	自身抗体			阳性率 (%)
组别	例数	TGAb 阳性	TPOAb 阳性	TPOAb和 TGAb均阳性	阳性率 (%)
甲亢	29	4	8	10	75.86
亚临床甲亢	38	5	2	7	36.84
甲减	21	2	1	10	61.90
亚临床甲减	156	8	13	50	45.51
合计	244	19	24	77	49.18

年龄 (岁)	总例数	甲减和亚临床甲减(例)	甲亢和亚临床甲亢(例)	TGAb 阳性(例)	TPOAb 阳性(例)	TPOAb和TGAb 均阳性(例)	阳性例数(%)
<20	5	0	0	1	0	0	1(20.00)
20~30	123	7	1	6	2	12	28(22.76)
31~40	603	22	6	37	24	46	135(22.39)
41~50	860	43	18	48	47	103	259(30.12)
51~60	512	20	11	34	27	69	161(31.45)
>60	239	15	4	15	12	22	68(28.45)
合计	2 342	107	40	141	112	252	652(27.84)