Graves甲亢^(131)I治疗中动态监测血清TPOAb的临床价值  

Clinical significance of serum TPOAb monitoring during^(131)I treatment in patients with Graves' disease

作　　者：李杨亮 陈烽[1] 刘柳[1] 

机构地区：[1]淮南新华医疗集团新华医院核医学科,安徽232052

出　　处：《国际检验医学杂志》2009年第10期960-962,共3页International Journal of Laboratory Medicine

摘　　要：目的探讨Graves甲状腺功能亢进症(简称甲亢)^(131)I治疗前后动态监测抗甲状腺过氧化物酶抗体(TPOAb)水平变化及其对治疗效果及预后的评判价值。方法112例Graves甲亢患者和50例健康对照者分别于^(131)I治疗前及治疗后3、6、12和24个月采用化学发光法(CLIA)测定其血清TPOAb水平。数据用(?)±s表示,组间差异用方差分析与t检验。结果112例Graves甲亢患者在^(131)I治疗前血清TPOAb水平[(81.95±47.64)IU/mL]高于健康对照组(P<0.01)。在^(131)I治疗后3个月血清TPOAb水平[(108.94±70.15)IU/mL]明显高于治疗前(P<0.01),治疗后6个月患者血清TPOAb水平[(42.78±28.68)IU/mL]开始降低,但与对照组比较差异仍有统计学意义(P<0.01),在^(131)I治疗12个月后血清TPOAb水平[(19.56±10.39)IU/mL]明显降低(P<0.01),到24个月患者血清TPOAb水平[(7.89±4.01)IU/mL]与对照组比较差异无统计学意义(P>0.05)。结论在^(131)I治疗前检测血清TPOAb水平可作为^(131)I用量的辅助指标;在^(131)I治疗后检测Graves甲亢患者的TPOAb水平有助于随访监测及疗效评价,还可了解治疗后的免疫反应状态。Objective The investigate the clinical significance of serum anti-thyroid peroxidase antibody（TPOAb） monitoring in therapeutic effect judgment and prognosis evaluation during ^131I treatment in patients with Graves＇ disease. Methods A total of 112 patients with Graves＇ disease（hyperthyroidism group） and 50 healthy controls（healthy control group） were enrolled in the investigation. Serum concentration of TPOAb was measured with chemiluminescent immunoassay（CLIA） in healthy control group and hyperthyroidism group（at time points of 0,3,6,12 and 24 months after ^131I treat ment,i, e. T0, T3, T6, T12 and T24 ）. Variance analysis and t test were adopted. Results The mean level of TPOAb was significantly higher in patients with Graves＇ disease before ^131I treatment than that in healthy controls（P〈0.01）. In hypenthyroidism group, serum concentration of TPOAb was evidently higher at T3[（108.94±70.15）IU/mL]than T0[（81.95±47.64）lU/mL]（P〈0.01） ;TPOAb level began to decline at T6[ （42.78±28.68）IU/mL], but still higher than that of healthy control group; while where was no statistical difference in TPOAb level between hyperthyroidism group at T24[（7.89 ± 4.01 ） IU/mL] and healthy control group （ P 〉 0.05 ）. Conclusion Serum level of TPOAb before treatment may be used as an auxiliary indicator of ^131I dosage. Posttreatment TPOAb level monitoring contributes to therapeutic effect evaluation,follow up visit and immunorcaction statc understanding.

关 键 词：格雷夫斯病 抗甲状腺过氧化物酶抗体 ^131Ⅰ治疗 甲状腺机能减退 

分 类 号：R446.62[医药卫生—诊断学] R581.1[医药卫生—临床医学]