男性Graves病患者药物治疗后血清免疫指标与性激素测定的临床意义  

Clinical Significance of Serum Immune Indicator and Sex Hormones in Patients with Male Graves' Disease After Treatment

作　　者：宋庆璋[1] 卢晓[1] 刘凝香[1] 王传新[2] 

机构地区：[1]山东省莱芜市人民医院检验科,271100 [2]山东大学齐鲁医院检验科,250003

出　　处：《放射免疫学杂志》2012年第4期394-396,共3页Journal of Radioimmanology

摘　　要：目的:为了探讨部分男性GD甲亢患者药物治疗后免疫缓解较慢的原因。方法:测定患者血清β2-m、T、E2、P的含量变化及TGA、TMA的阳性率变化,将176例男性GD甲亢患者根据治疗过程分为三组,①初发组(Ⅱ组,62例);②未缓解组(Ⅲ组,58例);③缓解组(Ⅳ组,56例);④60名正常人作为对照组(Ⅰ组)。结果:男性GD甲亢Ⅱ组与Ⅲ组血清β2-m、FT3、FT4、T、E2,P水平明显高于Ⅰ组(P<0.01),而TGA、TMA的阳性率明显下降(P<0.01)。Ⅱ组与Ⅲ组FT3、FT4与β2-m呈明显正相关,而Ⅳ组β2-m、FT3、FT4与Ⅰ组相比,差别无显著性(P>0.05)。而Ⅳ组T、E2、P水平虽明显降低,但与Ⅰ组相比差别仍有显著性(P<0.05),特别是Ⅳ组的T水平仍然较高与Ⅰ组相比差别有极显著性(P<0.01)。Ⅳ组与Ⅲ组相比,TGA、TMA阳性率差别无显著性(P>0.05)。Ⅳ组的TGA、TMA阳性率仍较高,与Ⅰ组相比差别仍有显著性(P<0.01)。最终Ⅳ组仍有21.4%的患者血清β2-m明显增高,26.8%的患者TGA、TMA仍持续阳性。结论:①血清β2-m水平及TGA、TMA阳性率可作为男性GD甲亢免疫缓解指标,男性GD甲亢患者未缓解者常有血清β2-m水平及TGA、TMA阳性率持续升高,提示免疫功能持续紊乱而不能缓解。②男性GD甲亢患者性腺轴功能恢复要慢于甲状腺功能恢复,患者体内血清T水平持续较高也提示免疫功能持续紊乱而缓解缓慢。Objective To study the cause of slow recovery and imcomplete remission in ceratin male Graves’ disease patients after treated with ATD.Methods The changes of serum β2-m,T,E2,P,TGA and TMA positive rates were measured in the following male subjects： A total of 176 male Graves’ disease patients were divided into 3 group by their different therapeutic effects：①untreated patients（group Ⅱ,n=62）,②treated but unrelieved patients（group Ⅲ,n=58）,③treated and recovered patients（group Ⅳ,n=56）,④and 60 normal person serving as controls（group Ⅰ）.Results The levels of serum β2-m,FT3,FT4,T,E2,P were significantly higher in group Ⅱand Ⅲ than those in group Ⅰ（P〈0.01）,but the positive rates of TGA and TMA were notably lower than those in group Ⅰ（P〈0.01）.There was a positive correlation between FT3 or FT4 and β2-m respectively in group Ⅱ and Ⅲ.There were no significant difference in β2-m,FT3 and FT4 between group Ⅳ and Ⅰ（P〉0.05）.Also there were no difference in the positive rates of TGA and TMA between group Ⅳ and Ⅲ（P〉0.05）.Serum T,E2,P levels in group Ⅳ were lower but higher than those in group Ⅰ（P〈0.05）.Particularly,there was still significantly higher T level in group Ⅳ than in group Ⅰ（P〈0.01）.The serum β2-m was still higher in 21.4% patients and the positive rates of TGA and TMA were also higher in 26.8% patients.About 24.1% of all male with Graves’ disease responded poorly to treatment.Conclusion ① Serum β2-m level,TGA and TMA positive rates could act as serum markers of immunological remission for male Graves’ disease patients.② The restoration of sexual gland function was lower than that of thyroid gland function in male Graves’ disease patients.Male Graves’ disease patients had sustained higher serum T level also suggest persistent disturbance of immune function.

关 键 词：男性 格雷夫斯病 免疫指标 性激素 

分 类 号：R581.1[医药卫生—内分泌]