Graves病中甲状腺自身抗体的动态变化及相关性分析

目的：研究Graves病（GD）发病时及在抗甲状腺药物治疗过程中促甲状腺素受体抗体（TRAb）和甲状腺过氧化物酶抗体（TPOAb）的变化。方法：应用ELISA对初发的和应用甲巯咪唑治疗不同阶段（3，6，12，18及24月）的GD患者血清进行TRAb、TPOAb检测。同时，对游离甲状腺素（FT4）、游离三碘甲腺原氨酸（FT3）和促甲状腺素（TSH）进行检测，并对TRAb、TPOAb和甲状腺功能（FT4，FL3，TSH）进行相关性分析。结果：232例初发的GD患者血清TRAb检测值中位数为0．86（OD405），阳性率为73．7％（171／232）；TPOAb检测值中位数为0．55（0D405），阳性率为28．9％（67／232）。治疗过程中，TRAb水平及阳性率稳步逐渐下降，而TPOAb水平在12个月前逐步上升，TPOAb阳性率也显示了上升趋势，然后逐渐下降。TRAb和TPOAb之间未发现相关性，它们与甲状腺功能之间也未发现相关性。结论：尽管TRAb和TPOAb是GD中的自身抗体，但它们反晦的是不同的免疫异常，而且这种免疫异常独立于甲状腺功能。

Evolution and correlation analysis of thyroid auto-antibodies in Graves' disease

Objective： To investigate the alteration and clinical significance of serum thyrotropin receptor antibody（TRAb） and thyroid peroxidase antibody （TPOAb） activities before and during treatment of Graves＇ disease （GD） with thiamazole. Methods： ELISA were used to measure the sera TRAb and TPOAb level before treatment and during the different treatment time （ 3, 6, 12, 18, and 24 months） in patients with GD. At the same time, the serum free thyroxine（FTa）, free triiodothyronine（FT3） and thyrotropin （TSH） were measured, the correlation of TRAb, TPOAb, FT3, FT4 and TSH were analyzed. Results： The serum TRAb value in 232 cases of initial GD was 0.86 expressed in median （M）, the prevalence was 73.1% （171/232）; The serum TPOAb value was 0.55（M） and the prevalence was 28.9% （67/232）. During the treatment, TRAb value and prevalence significantly decreased, but the TPOAb level got once increase in 12 months, and then gradually declined. There was no correlation between TRAb, TPOAb, and the thyroid function （FT3, FT4, TSH）. Conclusion： Although both TRAb and TPOAb are the autoimmune antibodies in GD, they might reflect different immune perturbations, and the pertaurbations are independently of thyroid function.