甲状腺动脉栓塞治疗Graves病对甲状腺自身抗体的影响

目的探讨甲状腺动脉栓塞治疗Graves病对甲状腺自身抗体的影响。方法对临床确诊的41例Graves病进行甲状腺动脉栓塞治疗。术前测定甲状腺自身抗体水平，术后随访3～61个月，依据患者症状、体征、甲状腺功能等观察疗效，并定期检测甲状腺自身抗体的滴度／活性和阳性率。结果Graves病时TRAb、TGAb、TMAb滴度／活性和阳性率高于正常水平，以TRAb更为显著。介入治疗6个月后有效组TRAb活性和阳性率降至正常水平，而复发组则仍保持较高水平。TGAb、TMAb滴度和阳性率于治疗前、后无明显变化。结论栓塞治疗可以间接地纠正Graves病免疫功能的紊乱，降低某些自身抗体的产生。栓塞治疗有效者术后6个月TRAb多降至正常水平，高于正常水平者提示复发可能，TRAb可作为判断手术疗效的指标之一；TGAb和TMAb对于判断手术疗效意义不大。

Effect on thyroid autoantibodies after therapeutic thyroid arterial embolization of Graves'' disease

Objective To investigate the effect on thyroid autoantibodies after therapeutic thyroid arterial embolization of Graves' disease.Methods Forty-one patients with Graves' disease underwent therapeutic thyroid artery embolization.The preoperative level of thyroid autoantibodies was detected.During the 3-61 months follow-up after operation,curative effect was definited by symptom,signs and color Doppler ultrasonography examination of thyroid,and titre/activities and positive rate of thyroid autoantibodies were regularly detected.Results Titre/activitis and positive rate of TRAb,TGAb and TMAb,especially of TRAb in all patients with Graves' disease were significantly higher than normal.Activity and positive rate of TRAb decreased to normal level six months after interventional therapy in the utility group,but others remained higher than normal in the recurrence group.There were no remarkably change of titre and positive rate of TGAb and TMAb before and after embolization.Conclusion Therapeutic thyroid arterial embolization can indirectly rectify the disorder of the immune function of Graves' disease,and cut the level of some thyroid autoantibodies down.It probably demonstrates amelioration that the level of TRAb decreases to normal six months after operation,or possibly represents recurrence that remains higher than normal.TRAb can be regarded as one of indexes definiting therapeutic effect.