血清TRAb IgG亚型在甲状腺相关性眼病患者中的特征及临床意义  

Characteristics and clinical significance of serum TRAb IgG subtype in patients with thyroid associated eye disease

作　　者：王秋怡 符畅 符茂雄 林升雄 WANG Qiu-yi;FU Chang;FU Mao-xiong(Department of Endocrinology,the Second Affiliated Hospital of Hainan Medical University,Haikou Hainan 570311,China)

机构地区：[1]海南医学院第二附属医院内分泌科,海南海口570311 [2]海南省人民医院内分泌科,海南海口570311

出　　处：《临床和实验医学杂志》2022年第4期367-370,共4页Journal of Clinical and Experimental Medicine

基　　金：海南省卫生厅自然科学项目(编号:16A200071)。

摘　　要：目的探究血清促甲状腺激素受体抗体(TRAb)IgG亚型在甲状腺相关性眼病(TAO)患者中的特征及临床意义。方法前瞻性选取2019年1月至2020年1月海南医学院第二附属医院收治的40例TAO患者作为TAO组,根据活动度评分(CAS)将患者分为活动期组(n=22)与静止期组(n=18),同期同院40名健康体检者作为对照组。收集所有受试者临床资料,比较各组血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)、抗甲状腺过氧化物酶抗体(TPOAb)、抗甲状腺球蛋白抗体(TGAb)、TRAb水平,检测血清TRAb IgG与IgG各亚型百分结合率,比较各亚型阳性率与阳性亚型的相对含量。结果TAO组患者FT3、TSH、TPOAb、TgAb、TRAb均显著高于对照组,差异均有统计学意义(P<0.05),血清FT4与对照组差异无统计学意义(P>0.05);活动期组与静止期组FT3、FT4、TSH、TPOAb、TgAb、TRAb比较,差异均无统计学意义(P>0.05)。TAO组TRAb IgG与IgG、IgG1、IgG2、IgG4百分结合率均高于对照组,差异均有统计学意义(P<0.05);活动期组IgG1高于静止期组,IgG4低于静止期组,差异均有统计学意义(P<0.05);活动期组TRAb IgG1阳性率为95.45%,明显高于静止期组(66.67%),差异有统计学意义(P<0.05);活动期组TRAb IgG4相对含量为0.18±0.02,明显低于静止期组(0.93±0.14),差异有统计学意义(P<0.05)。结论血清TRAb IgG亚型在TAO中具有一定的参与作用,且能够反映出疾病趋势,IgG1升高提示趋向于活动期,可为临床治疗提供依据。Objective To investigate the characteristics and clinical significance of serum thyroid stimulating hormone receptor antibody(TRAb)IgG subtype in patients with thyroid-associated eye disease(TAO).Methods Forty cases of TAO patients admitted to the Second Affiliated Hospital of Hainan Medical College from January 2019 to January 2020 were prospectively selected as TAO group.According to activity scale(CAS),patients were divided into active group(n=22)and stationary group(n=18),and 40 healthy subjects in the same hospital during the same period were selected as control group.Clinical data of all subjects were collected,and serum levels of free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH),anti-thyroid peroxidase antibody(TPOAb),anti-thyroglobulin antibody(TGAb)and TRAb in each group were compared.The percentage of TRAb IgG and IgG subtypes in serum was detected,and the relative content of positive subtypes and positive subtypes was compared.Results The levels of FT3,TSH,TPOAb,TgAb,and TRAb in the TAO group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in serum FT4 between the TAO group and the control group(P>0.05).There was no statistically significant difference between FT3,FT4,TSH,TPOAb,TgAb,TRAb between the active group and the stationary group(P>0.05).The percentage binding rates of TRAb IgG,IgG,IgG1,IgG2 and IgG4 in TAO group were higher than those in the control group,and the differences were statistically significant(P<0.05);IgG1 in the active group was higher than that in the rest group,IgG4 was lower than that in the rest group,and the difference was statistically significant(P<0.05);The positive rate of TRAb IgG1 in active group was significantly higher than that in stationary group,and the difference was statistically significant(P<0.05);The relative content of TRAb IgG4 in the active group was lower than that in the stationary group,and the difference was statistically

关 键 词：甲状腺相关性眼病 TRAB IGG亚型 活动期 静止期 活动度评分 

分 类 号：R771.3[医药卫生—眼科] R581[医药卫生—临床医学]