正确评价甲状腺激素自身抗体阳性患者的甲状腺功能

目的 甲状腺激素自身抗体(THAAb)可以干扰甲状腺激素的测定，使患者的临床表现与甲状腺功能测定结果不符，分析4例甲状腺激素测定时受THAAb干扰的病例，探讨如何正确评价THAAb阳性患者的甲状腺功能状态。方法 通过血清敏感促甲状腺激素(sTSH)水平、甲状腺摄^131I率、基础代谢率及促甲状腺激素释放激素(TRH)兴奋试验，综合评价患者甲状腺功能的实际状态；用聚乙二醇(PEG)沉淀血清中的THAAb，比较甲状腺激素水平在处理前、后的变化。结果 各项辅助检查的结果均与患者的临床表现一致；PEG处理血清后测得的甲状腺激素水平也与患者的临床表现一致。结论 对THAAb阳性患者可结合临床资料及其他辅助检查综合评价患者的甲状腺功能状态，也可用PEG沉淀THAAb后重复测定甲状腺激素水平，以正确评价患者的甲状腺功能。

Correct evaluation of thyroid function in patients with positive thyroid hormones autoantibodies

Objective To evaluate correctly the thyroid function in patients with thyroid hormones autoantibodies (THAAb).Methods Four THAAb-positive patients' thyroid function were evaluated according to the sensitive serum thyrotropin(sTSH), - 131-I uptake rate, basal metabolism rate and the result of thyrotropin releasing hormone(TRH) stimulating test. The levels of thyroid hormones after treatment of the sera with polyethylene glycol (PEG) were assayed again.Results The results of these tests and the levels of thyroid hormones after treatment of the sera with PEG were consistent with the patients' clinical symptomatology.Conclusion The thyroid function of THAAb-positive patients can be evaluated correctly through some special tests or assaying the levels of thyroid hormones after PEG treatment.