Graves病甲状腺功能亢进症患者β2微球蛋白的变化及意义

Change and significance of β2-microglobulin in the patients with Graves'hyperthyroidism

目的探讨Graves病甲状腺功能亢进症(GD甲亢)对β2-微球蛋白(β2-MG)的影响。方法采用放射免疫分析和化学发光免疫分析测定87例GD甲亢患者治疗前后FT3、FT4、TSH、血清及尿液β2-MG含量,并和40例健康对照组比较。结果治疗前β2-MG以及FT3、FT4含量显著高于对照组,TSH低于对照组(P<0.01);治疗后FT3、FT4及β2-MG含量与治疗前对比明显降低,TSH增高(P<0.01);治疗后与对照组差异无显著性(P>0.05)。好转及无效组β2-MG含量与FT3、FT4含量显著高于对照组,TSH低于对照组(P<0.01);复发组β2-MG含量与FT3、FT4含量升高,TSH降低,与对照组比较均(P<0.01);不同疗法β2-MG、FT3、FT4及TSH含量比较(P均>0.05)。治疗前β2-MG与FT3含量呈显著正相关;β2-MG与FT4含量呈显著正相关;与TSH呈负相关。结论甲状腺疾病患者β2-MG含量与甲状腺激素有密切关系,β2-MG可作为GD甲亢疗效观察、病情变化及预后判断的一项辅助诊断指标。

Objective To observe the changes and signifieane of β2 - mieroglobulin （β2 - MG） in the patients with Graves＇ Hyperthyroidism. Methods RIA and CLIA were used for determination of the levels of β2 - MG, FT3, FT4. TSH in serum and urine and serum of 87 patients with Graves hyperthyroidism before and after treatment and compared with 40 consols. Results The levels of β2 - MG, FT3, FT4 before treatment were significantly higher, while TSH lower, than those in the controls （P 〈 0.01）. After treatment, the levles of β2 - MG, FT3, FT4 in patients were significantly decreased, while the level of TSH increased compared with that before treatments （P 〈 0.01） and those in the controls （P 〉 0.05）. On the other hand, the levels ofβ2 - MG, FT3, FT4 in the improving group and invalid group were significantly higher than that of controls, but the level of TSH was decreased （ P 〈 0. 01 ）. The levels of β2 - MG, FT3, FT4 increased and TSH decreased in the recurrent group as compared with that of controls （ P 〈 0.01）, Before treatment the levels of FT3 and FT4 were positively correlated to that of β2- MG and the level of TSH was negative correlated toβ2 - MG. Conclusion The level of β2 - MG in the patients with thyroid disease are closely associated with the level of thyroid hormone, and the level of β2- MG in Graves＇ Hyperthyroidism will increase, When Graves＇ Hyperthyroidism improved, the level of β2 - MG will decerased slowly and the level of β2 - MG will drop to normal after cured. The level of β2- MG will again increase in case of recurrence .β2- MG can be used as an diagnostic indicator for observaion of the therapeutic effect, the change of disease and prognosis. The increase of level of β2 - MG in a patient indicates that the level of FT3 and FT4 be determined to prevent missing diagnosis of Hyperthyroidism of Graves＇ Disease.