甲状腺自身抗体对131I治疗青少年Graves病后甲减的影响

研究青少年Graves病(GD)患者治疗前促甲状腺激素受体抗体(TRAb)和甲状腺过氧化物酶抗体(TPOAb)水平对131I治疗后甲状腺功能减退症(甲减)发生率的影响.131I治疗青少年GD患者 264例,治疗前依TRAb和TPOAb分为TRAb阳性、阴性组及TPOAb强阳性、阳性和阴性组;依两抗体不同阳性组合分为A[...

Effect of Thyroid Auto-antibodies on Hypothyroidism of Adolescents with Graves Disease After 131I Treatment

To investigate the effect of TSH receptor antibody（TRAb）and thyroid peroxidase antibody（TPOAb）levels in adolescents with Graves disease（GD） before 131I treatment on the incidence of hypothyroidism after 131I therapy.The total 264 adolescent with GD were treated with 131I.All patients before the treatment were divided into A,B,C,D,E and F groups in accordance with the levels of TRAb and TPOAb in various combinations.The serum TSH,FT3,FT4,TRAb and TPOAb levels in all patients were measured after 131I treatment.The incidence of hypothyroidism within three years were observed in each group.The results showed that the incidence of hypothyroidism in TRAb negative group was higher than that of positive group（χ2=4.67,P0.05）.The incidence of hypothyroidism in TPOAb marked-positive and positive group was higher than that of negative P0.05）.The incidence of hypothyroidism in group C was lowest with7.07% and in group D was highest with33.33%.There was significant difference between group A and C,B and C,C and E（χ2=4.10,4.34,5.66,P0.05）.The levels of TRAb in patients with hypothyroidism in positive and negative group were increase after treatment（P0.01） and TPOAb levels were also increased in positive group（P0.05）.The thyroid Auto-antibodies play a role together in hypothyroidism of adolescents with GD after 131I therapy.It could be cautious in treatment of GD adolescents of TRAb negative and TPOAb positive with 131I.