促甲状腺激素受体抗体检测的临床意义  

Clinical implications of thyrotropin receptor antibody measurement

作　　者：杨昱[1] 刘超[1] 郑昂[2] 蔡可英[2] 

机构地区：[1]江苏省中西医结合医院内分泌代谢病院区,210028 [2]徐州医学院第二附属医院内分泌科

出　　处：《中华内分泌代谢杂志》2011年第4期360-364,共5页Chinese Journal of Endocrinology and Metabolism

摘　　要：50年前人们发现了促甲状腺激素受体抗体（TRAb）,随着对促甲状腺激素受体（TSHR）结构和功能认识的不断更新,加之TSHR信号转导和与TRAb相互作用的逐步阐明,人们对TRAb及其临床应用的认识得到了进一步提高.TRAb的检测在Graves病（GD）及Graves眼病的诊断中有重要作用,并有效预测GD经抗甲状腺药物或放射性碘治疗后复发.其亦可应用于近期服碘的孕妇和乳母,因为甲状腺扫描对她们来说是禁忌的.另外,TRAb有助于胎儿、新生儿甲状腺功能亢进及其他类型的甲状腺毒症的诊断和鉴别诊断.目前,已有文献报道TRAb阳性的GD患者发生甲状腺肿瘤及不良预后之间的可能联系,但尚需更多的前瞻性研究来证实.It has been 50 years since the discovery of thyrotropin receptor autoantibody （TRAb）. Advances in the knowledge of thyrotropin receptor （ TSHR） structure and function, combined with the elucidation of TSHR signaling and TSHR-autoantibody interaction have greatly facilitated our understanding of TRAb and their clinical applications. Measurement of TRAb activity plays an important role in the diagnosis of Graves＇ disease （ GD） and Graves＇ opthalmopathy. It has also been well recognized that TRAb is an effective predictor of GD relapse or remission after antithyroid drug and radioactive iodine treatment. TRAb test is of particular help in pregnant women and lactating mothers with recent iodine load, where radioactive iodine or technetium tests are contraindicated. In addition, it is useful in the diagnosis and differential diagnosis of fetal and neonatal hyperthyroidism as well as some rare forms of thyrotoxicosis in clinical practice. Accumulating evidence also indicates the possible correlation between thyroid cancer occurring in GD patients with positive TRAb and adverse outcomes. However, further innovation and standardization of TRAb tests are required to help pave the way for clinical applications.

关 键 词：促甲状腺激素 促甲状腺激素受体抗体 格雷夫斯病 方法学 

分 类 号：R581.1[医药卫生—内分泌]