临床活动性评分、血清透明质酸、促甲状腺素受体抗体与Graves眼病间的关系

目的　探讨临床活动性评分 (CAS)、血清透明质酸 (HA) ,促甲状腺素受体抗体 (TRAb)水平与Graves眼病 (Gravesophthalmopathy ,GO)活动性、严重度以及糖皮质激素治疗效果间的关系。 方法　GO组 33例 ,Graves病无眼病组 (noGravesophthalmopathy ,NGO) 2 5例 ,正常对照组 2 0例 ,用放免分析法和放射受体分析法测定 3组人群血清HA ,TRAb水平 ,GO患者计算CAS ,并用泼尼松治疗。以NOSPECS分级判断眼病严重度和激素治疗效果 ,比较 3组间及激素治疗有效组与无效组间各指标的差别和相关性。结果　GO组血清HA高于NGO组与正常对照组 ,差异有统计学意义。 3组TRAb水平比较 ,差异有统计学意义 ,表现为GO组 >NGO组 >正常对照组。血清TRAb水平与眼病严重度相关。治疗有效组CAS与血清HA水平高于治疗无效组 ,差异有统计学意义。结论　CAS、血清HA测定可作为判断GO活动性、预测糖皮质激素治疗效果的辅助手段。血清TRAb滴度在GO患者中高于NGO患者 ,可能预测GO的发生 ,并与眼病严重度评分相关

Relationship between clinical activity score,serum concentration of hyaluronan,thyrotropin receptor antibody and Graves ophthalmopathy

Objective To investigate the relationships between clinical activity score(CAS),serum concentration of hyaluronan(HA),thyrotropin receptor antibody(TRAb) and the activity,severity of Graves ophthalmopathy(GO),the clinical response to corcicosteroids therapy.Methods The above markers in 33 patients with GO,25 patients with Graves hyperthyroidism and 20 healthy controls.Serum concentrations of HA and TRAb were measured using radioimmunoassay. Patients with GO were assessed using clinical activity score and treated with cortisone.The severity of GO and clinical response to corcicosteroids was evaluated using NOSPECS Grade.Each marker was compared among these three groups,the same work was done between responders to corcicosteroids and those who did not respond.Results GO group had significantly higher serum concentration of HA than NGO and control group. There were significant differences among these three groups in serum concentrations of TRAb,that is GO>NGO>control.Serum concentration of TRAb was correlated with the severity of GO.The CAS and serum concentrations of HA were significantly higher in responders to corcicosteroids than those who did not respond.Conclusion CAS and serum concentration of HA could reflect the activity of GO and predict therapeutic outcome to corcicosteroids. GO group had significantly higher serum concentration of TRAb than NGO group.Serum concentration of TRAb could predict the episode of GO and correlates with the severity of GO.