甲状腺刺激性免疫球蛋白在甲亢药物治疗中意义的探讨  

Exploration on the Significance of Thyroid Stimulating Immunoglobulins in the Treatment of Hyperthyroidism

作　　者：黄乐华 陈楚坪 陈广树 朱平 冉建民 HUANG Lehua;CHEN Chuping;CHEN Guangshu;ZHU Ping;RAN Jianmin(Department of Endocrine Metabolism,Guangzhou RedCross Hospital/Guangzhou Emergency Hospital/Guangzhou Red Cross Hospital Afiliated to Jinan University/Internet Hospital of Guangzhou Red Cross Hospital,Guangzhou 510220,China)

机构地区：[1]广州市红十字会医院/广州市应急医院/暨南大学附属广州红十字会医院/广州市红十字会医院互联网医院内分泌代谢科,广东广州510220

出　　处：《临床医学工程》2024年第9期1065-1066,共2页Clinical Medicine & Engineering

基　　金：广东省钟南山医学基金会项目(ZNSJJH-XS-[2022]-[06]-[004])。

摘　　要：目的对比Graves病(GD)患者中,药物治疗(ATDs)与停药后的促甲状腺素受体抗体(TRAb)及甲状腺刺激性免疫球蛋白(TSI)水平,初步探讨其临床意义。方法选择225例广州红十字会医院门诊随访GD患者,收集患者首次检测TSI的资料,分析ATDs组与停药组的TRAb、TSI水平及其与甲状腺激素之间的关系。结果停药组TRAb、TSI水平明显低于ATDs组(P<0.05)。总组、ATDs组及停药组中TRAb和TSI呈显著正相关(P<0.05)。以是否停药建立TRAb、TSI的ROC曲线,TRAb最大约登指数界值为1.51 IU/L,TSI为0.36 IU/L(P<0.001);两者ROC曲线下面积(AUC)比较无统计学差异(P=0.33)。结论TSI与TRAb对于判断停药具有相同的预测价值,临床中亦可根据TSI水平指导甲亢药物治疗及评估停药。Objective To compare the TRAb and TSI levels in patients with Grave's disease(GD)during or after medication,and explore its clinical significance preliminary.Methods 225 GD patients at Guangzhou Red Cross Hospital were selected.The data at initial TSI detection were collected.The TRAb and TSI levels in ATDs group and discontinuation group,and their correlation with thyroid hormones were analyzed.Results The TRAb and TSI levels of the withdraw group were significantly lower than those of the ATDs group(P<0.05).The TRAb had significant positive correlation with TSI in the total group,ATDs group,and discontinuation group(P<0.05).The cut-off values for TRAb and TSI in the ROC curves after discontinuation of medication were 1.51 IU/L and 0.36 IU/L(P<0.001).Areas under the ROC curves(AUC)for TRAb and TSI lacked statistical significance(P=0.33).Conclusions TSI and TRAb equally predict treatment discontinuation.TSI level can guide hyperthyroidism drug therapy and evaluate discontinuation clinically.

关 键 词：抗甲状腺药物 促甲状腺素受体抗体 甲状腺刺激性免疫球蛋白 停药 

分 类 号：R581.1[医药卫生—内分泌]