TRAb检测作为Graves病患者停药指征及预后判断依据的临床研究

目的探讨促甲状腺素受体抗体（TRAb）对于判断毒性弥漫性甲状腺肿（Graves病）患者顸后的价值及其作为患者停药指征的可行性。方法选取2011年1月至2012年12月在市属三家医院治疗的264例Graves病患者，将其分为未治疗组（57例）、治疗控制组（53例）、治疗未控制组（46例）、停药复发组（49例）、停药未复发组（59例），另选50例正常体检者作为正常对照组。检测各组患者平均TRAb值，比较其差异。结果正常对照组TRAb平均水平为（1．49±0．31）IU／L，未治疗组为（34．87±5．38）IU／L，治疗控制组为（7．63±1．32）IU／L，治疗未控制组为（20．01±4．28）IU／L，停药复发组为（27．02±4．14）IU／L，停药未复发组为（2．38±0．41）。除停药未复发组以外，其他各组平均TRAb水平均显著高于正常对照组，差异具有统计学意义（P〈0．01）；治疗未控制组平均TRAb水平显著高于治疗控制组．差异具有统计学意义（P〈0．01）；停药复发组的平均TRAb水平显著高于停药未复发组，差异具有统计学意义（P〈0．01）。结论TRAb是评价Graves病控制情况和是否复发的重要指标，TRAb降至正常水平可作为Graves病患者停药的指征之

TRAb detection as graves disease indications and prognosis judgement on the basis of discontinuation of clinical studies.

Objective To study the role of thyroid hormone receptor antibody （TRAb） to judge the value of Graves disease prognosis and the feasibility of drug withdrawal indications as a patient. Methods 264 cases of Graves disease from January 2011 to December 2011 in three hospitals for the treatment were included into this study. All these patients were divided into the no treatment group （57 cases） and treatment con- trol group （53 cases） and treatment without control group （46 cases）, the recurrence after drug withdrawal group （49 cases）, no recurrence after withdrawal group （59 cases）, normal physical examination as normal control group （50 cases）. The average values of TRAb in all these patients were tested and compared their differences. Results TRAb average value in normal control group is （ 1.49 ±0.31 ） IU/L, no treatment group （34.87 ±5.38） IU/L, treatment controlled group （7.63 ±1.32） IU/L, treatment without control group （20.01 ±4.28 ） for IU/L, recurrence after withdrawal group （27.02 ±4.14 ） IU/L, without recurrence after withdrawal group （2.38 ± 0.41 ）. Besides no relapse after withdrawal group, the average TRAb level of other groups were significantly higher than that of normal control group. The difference has statistical significance （ P 〈 0.01 ） ; Treatment did not control the average TRAb level is significantly higher than control group, the difference is statistically significant （ P 〈0.01 ）. The TRAb in relapse group after drug withdrawal is significantly higher than the average level of no relapse withdrawal group. There was statistically significant difference （ P 〈 0.01 ）. Conclusion The TRAb is an important index of recurrence in Graves disease control and e- valuation. TRAb decreased to the normal levels can be used as one of the indications of Graves disease drug withdrawal.