Graves病患者血清TSAb、TBII和TGI的联合检测及临床价值

SIMULTANEOUS ASSAY OF TSAb、TBII AND TGI,AND ITS CLINICAL SIGNIFICANCE

同时检测Ｇｒａｖｅｓ病（ＧＤ）患者血清甲状腺刺激抗体（ＴＳＡｂ）、甲状腺生长免疫球蛋白（ＴＧＩ）和ＴＳＨ结合抑制免疫球蛋白（ＴＢＩＩ），并对部分病例停药后随访半年。结果显示：（１）ＧＤ未治组ＴＳＡｂ、ＴＢＩＩ和ＴＧＩ的活性与阳性率均显著高于ＧＤ缓解组和停药组，后两组差异无显著性，但其抗体的活性与阳性率仍高于正常对照组。（２）三种自身抗体的活性与血清甲状腺激素水平无显著相关性，但ＴＧＩ与甲状腺肿大程度显著正相关。（３）停药时ＴＳＡｂ、ＴＢＩＩ和ＴＧＩ均阳性或阴性者，停药半年内的复发率分别为０．７７８和０．０６６。提示联合测定甲状腺特异性抗体对阐明ＧＤ的发病机制、观察治疗效果、判断复发或缓解具有重要意义。

Thyroid-stimulating antibodies(TSAb),thyrotropin-binding inhibitor immunoglobulins(TBII)and thyroid growth im-munoglobulins(TGI) vvere assessed in patients with Graves disease(GD)and the clinical values of the assays were evaluated. Theresults showed that(1)The activities and positive rates of TSAb,TBII and TGI were much higher in patients with untreated GD ascompared to the patients with remitted GD and treated subjects.(2)No correlation was found between the activities of the three au-toantibodies and the serum levels of thyroid hormones. However, the activities of TGl were positively correlated to the degree ofgoiter.(3)The patients with positive TSAb,TBII and TGI at the time of discontinuation of antithyroid drugs had a higher relapserate than the patients with negative autoantibodies。The results indicate that sirnultaneous measurement of thyroid autoantibodieshelps in the understanding of pathogenesis,prediction of the prognosis and instruction of the treatment of GD.