血清TPOAb水平对Graves病患者抗甲状腺药物治疗的影响  

Effects of serum level of TPOAb on Graves disease in patients using anti-thyroid drug treatment

作　　者：卢泽芬 于佳[2] 任丽萍[3] 郝杰 何庆[4] 

机构地区：[1]沧州市人民医院,061000 [2]天津市海河医院 [3]天津大学医院 [4]天津医科大学总医院

出　　处：《天津医药》2016年第6期769-771,共3页Tianjin Medical Journal

基　　金：国家自然科学基金资助项目(81170740)

摘　　要：目的分析血清甲状腺过氧化物酶抗体(TPOAb)水平对初发Graves病(GD)患者抗甲状腺药物(ATD)治疗的影响。方法选择应用ATD治疗满12个月的初发GD患者121例,将其分为TPOAb阴性组49例(TPOAb≤35 IU/m L)和阳性组72例(TPOAb>35 IU/m L),根据TPOAb滴度水平将阳性组分为阳性低组(35 IU/m L<TPOAb≤200 IU/m L,19例)、中组(200 IU/m L<TPOAb≤500 IU/m L,20例)、高组(500 IU/m L<TPOAb≤1 000 IU/m L,13例)、极高组(TPOAb>1 000 IU/m L,20例),比较治疗12个月各组ATD总用量以及治疗3、6、12个月时阴性组和阳性组促甲状腺激素(TSH)恢复正常的比例。结果 TPOAb阳性组ATD的总用药量为(1 743.82±265.38)mg,低于阴性组(1 889.18±125.51)mg;TPOAb阳性低、中、高、极高组总用药量分别为(1 759.71±230.29)mg、(1 793.75±299.02)mg、(1 731.54±236.44)mg和(1 710.00±290.73)mg。TPOAb阳性组在治疗3个月时TSH恢复正常的比例明显高于阴性组(P<0.05)。结论 GD患者血清TPOAb阳性会导致ATD治疗的疗程缩短、总用药量减少。Objective To analyse effects of the serum levels of thyroid peroxidase antibodies (TPOAb) on antithyroid drugs (ATD) treatment in patients with incipient Graves disease (GD). Methods A total of 121 patients with incipient GD, who were used anti thyroid drugs for 12 months, were included in this study. Patients were dvided into two groups:TPOAb negative group (TPOAb≤35 IU/mL, n=49) and TPOAb positive group (TPOAb>35 IU/mL, n=72). According to the degree of TPOAb drops the TPOAb positive group was sub-divided into low level positive group (35 IU/mL<TPOAb≤200 IU/mL, n=19), medium level positive group (200 IU/mL<TPOAb≤ 500 IU/mL, n=20), high level positive group (500 IU/mL<TPOAb≤1 000 IU/mL, n=13), and very high level positive group (TPOAb>1 000 IU/mL, n=20). The ATD total dosage for 12 months and thyroid-stimulating hormone (TSH), which returned to normal rate after treatment of 3, 6 and 12 months, were compared between groups. Results ATD total dose was lower in TPOAb positive group (1 743.82±265.38) mg than that of negative group (1 889.18 ±125.51) mg. The ATD total dosages were (1 759.71±230.29) mg, (1 793.75±299.02) mg, (1 731.54± 236.44) mg and (1 710.00 ± 290.73) mg for low level TPOAb positive group, medium level TPOAb positive group, high level TPOAb positive group, and very high level TPOAb positive group respectively. The recovering ratio of TSH was significantly higher in TPOAb positive group than that of TPOAb negative group after 3-month treatment (P<0.05). Conclusion TPOAb positive serum can lead to shorten the course of ATD treatment and reduce the total amount of ATD treatment in GD patients.

关 键 词：格雷夫斯病 过氧化物酶 自身抗体 甲状腺 抗甲状腺药 用药剂量 

分 类 号：R581.1[医药卫生—内分泌]