Graves病中甲状腺自身抗体的动态变化及相关性分析  

Evolution and correlation analysis of thyroid auto-antibodies in Graves' disease

作　　者：章清华[1] 方佩华[1] 张艳丽[1] 李宁[1] 冯凭[2] 张宝泉[1] 王英姿[2] 

机构地区：[1]天津医科大学总医院核医学科,天津300052 [2]天津医科大学总医院代谢病科,天津300052

出　　处：《天津医科大学学报》2010年第3期406-409,共4页Journal of Tianjin Medical University

基　　金：天津市科技发展计划项目(05YFGDSF02700)

摘　　要：目的:研究Graves病(GD)发病时及在抗甲状腺药物治疗过程中促甲状腺素受体抗体(TRAb)和甲状腺过氧化物酶抗体(TPOAb)的变化。方法:应用ELISA对初发的和应用甲巯咪唑治疗不同阶段(3,6,12,18及24月)的GD患者血清进行TRAb、TPOAb检测。同时,对游离甲状腺素(FT4)、游离三碘甲腺原氨酸(FT3)和促甲状腺素(TSH)进行检测,并对TRAb、TPOAb和甲状腺功能(FT4,FT3,TSH)进行相关性分析。结果:232例初发的GD患者血清TRAb检测值中位数为0.86(OD405),阳性率为73.7%(171/232);TPOAb检测值中位数为0.55(OD405),阳性率为28.9%(67/232)。治疗过程中,TRAb水平及阳性率稳步逐渐下降,而TPOAb水平在12个月前逐步上升,TPOAb阳性率也显示了上升趋势,然后逐渐下降。TRAb和TPOAb之间未发现相关性,它们与甲状腺功能之间也未发现相关性。结论:尽管TRAb和TPOAb是GD中的自身抗体,但它们反应的是不同的免疫异常,而且这种免疫异常独立于甲状腺功能。Objective： To investigate the alteration and clinical significance of serum thyrotropin receptor antibody（TRAb） and thyroid peroxidase antibody （TPOAb） activities before and during treatment of Graves＇ disease （GD） with thiamazole. Methods： ELISA were used to measure the sera TRAb and TPOAb level before treatment and during the different treatment time （ 3, 6, 12, 18, and 24 months） in patients with GD. At the same time, the serum free thyroxine（FTa）, free triiodothyronine（FT3） and thyrotropin （TSH） were measured, the correlation of TRAb, TPOAb, FT3, FT4 and TSH were analyzed. Results： The serum TRAb value in 232 cases of initial GD was 0.86 expressed in median （M）, the prevalence was 73.1% （171/232）; The serum TPOAb value was 0.55（M） and the prevalence was 28.9% （67/232）. During the treatment, TRAb value and prevalence significantly decreased, but the TPOAb level got once increase in 12 months, and then gradually declined. There was no correlation between TRAb, TPOAb, and the thyroid function （FT3, FT4, TSH）. Conclusion： Although both TRAb and TPOAb are the autoimmune antibodies in GD, they might reflect different immune perturbations, and the pertaurbations are independently of thyroid function.

关 键 词：GRAVES病 促甲状腺素受体抗体 过氧化物酶抗体 

分 类 号：R581[医药卫生—内分泌]