甲巯咪唑治疗Graves病甲状腺功能亢进症患者前后血清ZAG水平的变化

目的 通过检测初发Graves病(GD)患者及甲巯咪唑(MMI)治疗前后血清锌-α2-糖蛋白(ZAG)水平的变化,探讨ZAG在GD中的作用及意义.方法 采用ELISA法检测健康人群、初诊GD患者及MMI治疗12周后ZAG浓度,利用电化学发光法检测血清甲状腺激素、甲状腺相关自身抗体水平,采用酶法检测血脂水平;并进一步分析初发GD患者血清ZAG与甲状腺功能、甲状腺相关自身抗体及血脂水平等的关系.结果 初发GD患者血清ZAG、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)、抗甲状腺球蛋白抗体(TGAb)、抗甲状腺髓过氧化物酶抗体(TPO)和促甲状腺素受体抗体(TRAb)水平显著高于年龄、性别相匹配的健康人群,而促甲状腺激素(TSH)明显低于正常对照组(P＜0.05);初发GD经过MMI治疗12周后,血清ZAG、FT3、FT4、TT3、TT4、TRAb均明显降低;而TSH水平显著升高(P＜0.05).相关性研究显示:GD患者空腹血清ZAG水平与FT3、FT4、TT3及TT4呈正相关(P＜0.05);而与TSH、TG、TC、FFA呈负相关(P＜0.05).以GD患者空腹血清ZAG浓度为应变量,多元线性逐步回归分析表明,TSH、TG及TC分别是血浆ZAG水平的独立相关因素.结论 血清ZAG水平与GD发生、发展密切相关,并可能在GD患者血脂代谢中发挥着重要的作用.

Change of serum zinc-α2-glycoprotein level before and after methimazol treatment in hyperthyroidism patients with Graves disease

Objective To explore the roles and possible significance of zinc-α2-glycoprotein(ZAG) in Graves disease(GD) by detecting the change of serum ZAG level before and after methimazol(MMI) treatment in the patients with initial onset of Graves disease.Methods The enzyme linked immunosorbent assay(ELISA) was adopted to detect serum ZAG level in healthy population,patients with newly diagnosed GD and GD patients treated by 12-week MMI treatment.The serum thyroid hormones and thyroid related autoantibodies were determined by adopting the electrochemiluminescence immunoassay.The blood lipid levels were examined by enzymatic colorimetry.Furthermore the relationship between serum ZAG level with thyroid function,thyroid related autoantibodies and blood lipid in the patients with initial onset of GD was analyzed.Results The levels of ZAG,FT3,FT4,TT3,TT4,TGAb,TPO and TRAb in the patients with newly diagnosed GD were much higher than those in the age-and gender-matched normal healthy population,while the TSH level was significantly lower than that in the normal control group(P＜0.05);after 12-week MMI treatment in the patients with initial onset of GD,the levels of serum ZAG,FT3,FT4,TT3,TT4 and TRAb were markedly decreased,whereas the TSH level was significantly enhanced(P＜0.05 or P＜0.01).The correlation study showed that fasting serum ZAG level in the GD patients was positively correlated with FT3,FT4,TT3 and TT4(P＜0.05);and negatively correlated with TSH,FFA,TC and TG(P＜0.05).With fasting serum ZAG in the GD patients as the dependent variable,the multiple linear regression analysis showed that TSH,TC and TG were the independent related factors of plasma ZAG level.Conclnsion The serum ZAG level is closely correlated with the occurrence and development of GD,and might play an important role in the blood lipids metabolism of GD patients.