桥本甲状腺炎甲状腺功能减退患者血清中TRAb、TSAb和TSBAb的表达及其意义  

THE EXPRESSION AND SIGNIFICANCE OF SERUM TRAb,TSAb,AND TSBAb IN PATIENTS WITH HASHIMOTO’S THYROIDITIS WITH HYPOTHYROIDISM

作　　者：薛羽 贾真妍 杜云赛 公倩 杜文华 高冠起 XUE Yu;JIA Zhenyan;DU Yunsai;GONG Qian;DU Wenhua;GAO Guanqi(Eleventh Clinical Medical College of Qingdao University,Department of Endocrinology,Linyi People’s Hospital,Linyi 276003,China)

机构地区：[1]青岛大学第十一临床医学院,临沂市人民医院内分泌科,山东临沂276003

出　　处：《精准医学杂志》2023年第6期490-493,共4页Journal of Precision Medicine

基　　金：山东省自然科学基金(ZR2011HM067);临沂市人民医院研究生培养基金(YJS2019015)。

摘　　要：目的探讨桥本甲状腺炎甲状腺功能减退(HT甲减)患者血清中促甲状腺素受体抗体(TRAb)、甲状腺刺激性抗体(TSAb)和甲状腺刺激阻断性抗体(TSBAb)表达的变化及其意义。方法收集133例HT甲减患者(HT甲减组)和125例健康体检者(对照组)的临床资料,检测研究对象血清中游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)和TRAb的水平并进行比较。检测HT甲减TRAb阳性组(B组)、HT甲减TRAb阴性组(C组)和健康阴性组(A组)血清中TSAb和TSBAb的水平并进行比较。Pearson相关分析分析HT甲减患者血清中TSAb、TSBAb表达水平与血清中FT3、FT4、TSH、TRAb水平的关系。结果与对照组相比,HT甲减组血清中TRAb表达水平升高(Z=-5.434,P<0.05)。与A组相比,B组血清中TRAb、TSBAb表达水平和TSBAb阳性表达率升高(Z=6.228,F=17.985,t=7.767,χ^(2)=15.273,P<0.05);与C组相比较,B组血清中TRAb、TSBAb表达水平和TSAb、TSBAb阳性表达率升高(Z=5.732,F=17.985,t=7.056,χ^(2)=62.115、52.000,P<0.05)。Pearson相关分析显示,HT甲减患者血清中TSBAb表达水平与血清中TRAb水平呈正相关(r=0.756,P<0.05)。结论血清中TSBAb表达升高可能是HT甲减患者发病的重要因素,对于血清中TRAb阳性的HT甲减患者应注意检测TSBAb的表达。Objective To investigate the changes in serum thyrotropin receptor antibody(TRAb),thyroid stimulating antibody(TSAb),and thyroid-stimulating blocking antibody(TSBAb)and their significance in patients with Hashimoto’s thyroiditis with hypothyroidism(HT hypothyroidism).Methods A total of 133 patients with HT hypothyroidism(HT hypothyroidism group)and 125 healthy subjects(control group)were enrolled and their clinical data were collected.The serum levels of free triiodothyronine(FT3),free thyroxine(FT4),thyrotropin(TSH),and TRAb were measured and compared between the two groups.TSAb and TSBAb were also compared across the patients who were positive for TRAb(group B),who were negative for TRAb(group C),and the healthy subjects who were negative for TRAb(group A).A Pearson correlation analysis was used to examine the relationships between the serum levels of TSAb and TSBAb and the serum levels of FT3,FT4,TSH,and TRAb in patients with HT hypothyroidism.Results The serum TRAb level in the HT hypothyroidism group was significantly higher than that in the control group(Z=-5.434,P<0.05).Compared with group A,group B showed significantly higher serum levels of TRAb and TSBAb and positive rate of serum TSBAb(Z=6.228,F=17.985,t=7.767,χ^(2)=15.273,P<0.05);compared with group C,group B had significantly higher serum levels of TRAb and TSBAb and positive rates of serum TSAb and TSBAb(Z=5.732,F=17.985,t=7.056,χ^(2)=62.115,52.000,P<0.05).The Pearson correlation analysis showed that the serum TSBAb level in patients with HT hypothyroidism was positively correlated with their serum TRAb level(r=0.756,P<0.05).Conclusion The increased expression of TSBAb in serum may be an important factor in the pathogenesis of HT hypothyroidism.For HT hypothyroidism patients with positive serum TRAb,attention should be paid to the measurement of their serum TSBAb expression.

关 键 词：桥本病 甲状腺功能减退症 自身抗体 促甲状腺素受体抗体 甲状腺刺激性抗体 甲状腺刺激阻断性抗体 

分 类 号：R581.4[医药卫生—内分泌] R581.2[医药卫生—内科学]