甲状腺自身抗体水平与Graves'病^(131)I治疗效果相关性分析  

Analysis in correlation between levels of thyroid auto- antibodies and efficacy of ^(131)I therapy in Graves' disease

作　　者：马玉波[1] 周雯婷[1] 顾爱春[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院核医学科,上海200011

出　　处：《实用临床医药杂志》2015年第21期66-72,81,共8页Journal of Clinical Medicine in Practice

摘　　要：目的回顾分析Graves'disease(GD)甲亢131I治疗前甲状腺自身免疫抗体水平及与疗效的相关性。方法依摄131I率公式并结合临床经验确定131I剂量,门诊治疗GD患者453例。首次治疗未愈或复发者,相隔3个月以上同法重复治疗,直至治愈。随访疗效1年以上,并根据治疗前TGAb、TPOAb、TRAb三种抗体水平是否正常各分为阴性和阳性2组,比较抗体水平与疗效差异及其相关性。结果 :1三种抗体阳性率各为53.8%(119/221)、84.4%(353/418)和93.6%(262/280),后两者明显高于TGAb(χ2=68.56和104.84,均P<0.01);2131I活度、首次治愈率、无效复发、早发和晚发甲减:三种抗体各自的阴阳两组比较,差异无统计学意义;3三种抗体之间早发和晚发甲减总例数比较,差异无统计学意义;4每种抗体水平与甲减率之间未见明显相关性(P>0.05)。结论 GD患者TPOAb和TRAb阳性率明显高于TGAb;三种抗体水平与首次治愈率和甲减发生率等疗效无相关性,不必为此而刻意控制131I剂量。Objective To analyze the correlation between levels of thyroid auto- antibodies and the efficacy of131 I therapy in Graves＇ disease. Methods A total of 453 clinic GD patients were treated by131 I,and doses were calculated by131 I uptake formula and clinical experience. Patients not cured or relapsed were treated repeatedly by the same way after 3 months until cured. The patients were followed up more than one year,then they were divided into positive group and negative group according to the levels of TGAb,TPOAb and TRAb before treatment. Then the data was processed with statistical analysis. Results ① The positive rates of these three antibodies were 53. 8%,84. 4% and93. 6% respectively in 453 patients,there were significant differences between the latter two and TGAb（ χ^2= 68. 56,104. 84,P〈 0. 01）; ② There were no significant differences between positive group and negative group in131 I doses,first time cure rate,invalid recurrence,early and later hypothyroidism（ P〈 0. 05）;③ There were no significant differences among these three antibodies in early and later hypothyroidism（ P〈 0. 05）; 4 There was no significant correlation between the level of every antibody and hypothyroidism rate（ P〈 0. 05）. Conclusion The levels of TPOAb and TRAb are significantly higher than TGAb in GD patients,and there is no significant correlation between the levels of these three antibodies and the efficacy of131 I therapy（ like first time cure rate and hypothyroidism rate）,so we should not sedulously control the doses of131 I for levels of autoantibodies.

关 键 词：Grave's病 131^I 自身抗体 甲状腺功能减退症 回顾分析 

分 类 号：R581.1[医药卫生—内分泌]