105例Graves病与5年随访再论其与桥本氏甲状腺炎的关系

105 CASES OF GRAVES’HYPERTHYROIDISM WITH FIVE-YEAR EOLLOW-UP STUDY OF THE RELATIONSHIP BETWEEN GRAVES’AND HASHIMOTO’S DISEASE

１０５例Ｇｒａｖｅｓ病（ＧＤ）于治疗前及治疗后５年分别进行甲状腺细针抽吸细胞涂片（ＦＮＡ），甲状腺功能，抗ＴＭＡ、抗ＴＧＡ检查，结果：（一）第１次ＦＮＡ，７５例为ＧＤ，３０例桥本氏甲状腺炎（ＨＴ）；第２次ＦＮＡ，７５例ＧＤ中，１０例转为ＨＴ，血抗ＴＭＡ及／或抗ＴＧＡ均较初次升高；３０例ＨＴ中，５例转为ＧＤ，血抗ＴＭＡ及／或抗ＴＧＡ均较初次下降。（二）５年随访，共１０例ＧＤ自发进入甲减或亚临床甲减，其中１例又由甲减回复到正常。作者认为ＦＮＡ、自身抗体及甲状腺功能相关，ＧＤ与ＨＴ可以互相转变。

five-year follow-up study was done on 105 cases of Graves’ hyperthyroidismbefore and after receiving antithyroid drugs.All cases were examined with fine needleaspiration(FNA)of biopsy.Serum TT3,TT4.TSH,anti-TMA and anti-TGA weredetermined.It showed that(1)Among the 105 cases,75 cases were diannosed as Gra-ves’disease(GD), and 3 0 cases as Hashimoto’s disease(HT)by the first FNA study;10 of the 75 GD cases evolved to be HT with increased titers of anti-TMA and /oranti-TGA,5 of the 30 HT cases turned out to be GD with decreased titers of anti-TMAand/or anti-TGA by the second FNA,(1) In five-year follow-up study of 105 cases,there were 10 cases that spontaneously developed hypothyroidism or subclinical hypothy-roidism. One of them had clinical recovery with normal thyroid function,These datasuggested that FNA,autoantibodies and thyroid functions are interrelated. GD and HTare interconvertible.