Graves甲亢患者131I治疗后早期TRAb及TSAb变化的研究分析

目的 探讨和分析131I治疗Graves甲亢后早期促甲状腺素受体抗体(TRAb)和甲状腺刺激抗体(TSAb)的变化及其相关性。 方法 随机选择了89例Graves甲亢患者, 其中, 未行131I治疗的47例患者为对照组, 131I治疗后3个月的42例甲亢患者为观察组。两组患者均进行了血清游离三碘甲状腺原氨酸(FT₃)、血清游离甲状腺素(FT₄)、TSH、TRAb、TSAb和甲状腺刺激阻断性抗体(TSBAb)的测定。FT₃、FT₄、TSH采用化学发光法测定。TRAb采用放射受体分析法测定。TSAb、TSBAb采用酶联免疫法测定。 结果 观察组和对照组中的TRAb阳性率分别为78.6%(33/42)和36.2%(17/47);TSAb、TSBAb阳性率分别为38.1%(16/42)、0(0/42)和53.2%(25/47)、6.4%(3/47);TSAb与TRAb均为阳性的病例数分别为13例、15例; TSBAb为阳性的病例数分别为0例和3例, 其中3例TSBAb阳性的患者, 2例伴有TSAb和TRAb阳性, 1例伴有TSAb阳性和TRAb阴性。 结论 131I治疗后3个月时, 多数Graves甲亢患者的血清TRAb异常增高; 131I治疗后早期异常升高的TRAb只有部分(39.4%, 13/33)显示TSAb增高, 表明131I治疗后异常升高的TRAb多数并无TSAb功能。

Analysis of the changes in early TRAb and TSAb after 131I treatment for patients with Graves hyperthyroidism

Objective To investigate and analyze the changes of early thyroid stimulating hormone receptor antibody (TRAb) and thyroid stimulating antibody (TSAb) after 131I treatment for Graves hyperthyroidism and their correlation.Methods Eighty-nine patients with Graves hyperthyroidism were randomly selected in this study.The patients were divided into two groups: Group 1 (control group) : 47 patients who did not receive 131I treatment;Group 2 (study group) : the remaining 42 patients who received 131I treatment before 3 months.Serum FT3, FT4, TSH, TRAb, TSAb, and TSBAb values were measured for all patients in two groups.FT3, FT4, and TSH valued were determined by chemiluminescence method.TRAb values were determined by radiation receptor analysis.TSAb and TSBAb values were determined by enzyme-linked immunosorbent assay.Results The positive rates of TRAb values in study group and control group were 78.6％ and 36.2％ respectively.The positive rates of TSAb and TSBAb values in study group and control group were 38.1％(16/42), 0(0/42)and 53.2％(25/47), 6.4％(3/47),respectively;the number of patients with positive TSAb and TRAb simultaneously in the study and control groups were 13 (16 cases with positive TSAb and 33 cases with positive TRAb)and 15 cases (25 cases with positive TSAb and 17 cases with positive TRAb), respectively;the number of patients with positive TSBAb in the study and control groups were 0 and 3 cases, respectively.Two of three patients with positive TSBAb were positive TSAb and TRAb, simultaneously, 1 of 3 patients with positive TSBAb were positive TSAb and negative TRAb.Conclusions The serum TRAb value in the majority of patients with Graves hyperthyroidism increased in 3 months after 131I treatment.The TSAb value in the part of patients with increased TRAb(39.4％, 13/33) were abnormally high, showing that increased serum TRAb in 3 months after 131I treatment could not perform the same function as TSAb.