甲状腺刺激抗体作为Graves病预后指标的评价

以甲状腺刺激抗体（ＴｓＡｂ）及促甲状腺激素释放激素（ＴＲＨ）兴奋试验为指标，观察了５８例Ｇｒａｖｅｓ病（ＧＤ）患者抗甲状腺药物治疗前后ＴｓＡｂ变化及其作为评估ＧＤ预后的临床价值。结果显示：ＴｓＡｂ活性治疗前显著高于治疗后，经药物治疗后，ＴｓＡｂ明显下降或消失；停止治疗时，ＴｓＡｂ阳性或ＴＲＨ兴奋试验无反应者，ＧＤ复发率均为９３％；对复发组患者进一步分析后发现，停药时ＴｓＡｂ阳性率与ＴＲＨ兴奋试验不反应率分别为８４％和４５％，但二者间未能证实有相关关系；复发组平均治疗时间显著短于未复发组。以上结果表明，抗甲状腺药物具有一定的免疫抑制作用，反映ＧＤ免疫紊乱的ＴｓＡｂ用于估计预后时优于ＴＲＨ兴奋试验，治疗时间对复发与否有显著的影响。

The prognostic value of thyroid stimulating antibodiesaftcr antithyroid drug treatment of Gravcs, disease

hyroid stimulating antibodies (TsAb) andthyrotropin realeasing hormone (TRH) test were usedas the indices for predicting relapse and remission in58 patients. The variation of TsAb activities was ob-served before and after antithyroid drug (ATD) treat-ment. The findings showed that TsAb activities ofuntreated patients were significantly higher than thoseof patients treated by ATD, and TsAb activities wereweak or negative after ATD treatment. When TsAbwas positive or TRH test was abnonnal at the time ofcessation of ATD therapy, nearly 93% patients re-lapsed. Further analyses of relapsed patients indicatedthat there was no coirelation between the two indica-tors, andthe TsAb positive rate (84%) wassignificantly higher than the rate of abnormal TRHtest (45%). The average ATD treatment duration inrelapsed patients was shorter than that in remissionpatients. It is concluded that TsAb is more useful thanTRH test when they are used for predicting theprognosis of Graves' disease. The duration of ATDtreatment could affect relapse or remission. Theimmunosuppression effect of ATD was also identified.