血清、尿液β_2-m对G raves’病患者检测的临床意义  

Clinical Significance of Determination of Serum and Urine β_2-microglobulin(β_2-m) in Patients with Graves' Disease

作　　者：王鲁华[1] 麦芒[1] 欧阳小青[1] 王淑华[2] 林琛[1] 方琳丽[1] 

机构地区：[1]广东省汕头大学医学院第一附属医院,515041 [2]汕头大学医学院

出　　处：《放射免疫学杂志》2005年第6期427-429,共3页Journal of Radioimmanology

摘　　要：目的:探讨血清、尿液β2-微球蛋白(β2-m icroglobu lin,β2-m)对毒性弥漫性甲状腺肿(graves d is-eases,G raves)患者β2-m含量与甲状腺激素的关系,了解其变化情况及临床意义。方法:采用放射免疫分析和化学发光免疫分析测定了82例G raves病初发未治疗组与同一组经治疗的69例缓解组及13例未缓解组。并和40例健康对照组进行血清、尿液β2-m含量与FT3、FT4、TGA、TMA血清检测。结果:初发组与未缓解组β2-m含量与FT3、FT4含量显著高于健康对照组(P<0.01)。经治疗组β2-m含量与FT3、FT4含量同步缓解而下降至正常,与未治疗组对比(P<0.01)。对比健康正常组差异无显著性(P>0.05)。82例G raves病初发组TGA阳性率为48.7%(40/82),TMA阳性率为53.66%(44/82)。未缓解组TGA阳性率为15.38%(2/13),TMA阳性率为23.07%(3/13)。缓解组TGA、TMA仍有13.04%、15.94%阳性。结论:甲状腺疾病患者β2-m含量与甲状腺激素有密切关系,提示β2-m可作为G raves病疗效观察、病情变化及预后判断的一项辅助诊断指标。Objective To explore the relationship between the serum, urine contents of β2-m and serum thyroid hormones levels in patients with Graves＇ disease. Methods Serum, urine β2-m contents （ with RIA）, serum FT3、FT4 levels （ with CLIA）, TGA, TMA positive rates （with RIA） were determined in 82 patients with Graves＇ disease both before and after treatment as well as in 40 controls. Results The serum and urine β2-m contents as well as the serum FT3,FT4 levels in the 82 hyperthyroid patients before treatment were significantly higher than those in the controls （P 〈 0.01 ）. After treatment, 69 patients became euthyroid and their β2-m, FT3、FT4 levels dropped to approaching normal （vs controls, P 〉0.05）. In the 13 treatment failures, the levels remained significantly higher than those in controls （P 〈 0.01 ）. The positive rate of TGA and TMA in the patients before treatment were 48.78% （40/82） and 53.66% （44/82） respectively. The positive rate dropped markedly to 15.38% （2/13） and 23.07% （3/13） respectively even in the treatment failures. However, in the patients successfully treated, a substantial number remaind TGA and TMA positive （13.04% and 15.94% respectively）. Conclusion In patients with Graves＇ disease, changes of β2-m contents after treatment paralled those of FT3、FT4 levels. β2-m could be used as a diagnostic indicator for hyperthyroidism.

关 键 词：毒性弥漫性甲状腺肿 Β2-微球蛋白 游离三碘甲状腺原氨酸 游离甲状腺素 血清 尿液 

分 类 号：R581.1[医药卫生—内分泌] R587.1[医药卫生—内科学]