Влияние эндогенных и экзогенных факторов на иммунологические тесты оценки функции щитовидной железы

Лабораторная диагностика эндокринных заболеваний за последние десятилетия претерпела множество важных изменений, но, несмотря на прогресс технологий иммуноаналитических тестов, используемых для оценки функции щитовидной железы, нельзя полностью исключить факторы, способные изменять концентрацию исследуемого вещества, что может, в свою очередь, приводить к неправильной интерпретации и последующим ошибочным клиническим решениям. Вероятность таких ошибочных результатов составляет около 1%. Однако масштаб проблемы может быть больше вследствие неосведомленности врачей о данной проблеме и отсутствия лабораторного скрининга на наличие вмешивающихся факторов. Данные факторы могут быть как эндогенными, так и экзогенными, связываться как с антителами к исследуемому веществу, так и реагентом в тест-системе. Специфичность иммуноанализа зависит не только от связывающих свойств антитела, активности реагента, но также от состава тест-панели и формата методики (неконкурентный двухсайтовый или «сэндвич-формат» и конкурентный иммуноанализ).

В этом обзоре представлено описание основных аналитических ошибок, которые влияют на измерение гормонов щитовидной железы, в частности тиреотропного гормона, свободных тироксина и трийодтиронина, кальцитонина, приводятся клинические примеры, описанные в литературе за последние несколько лет.

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