Graves病甲状腺功能亢进患者免疫球蛋白和抗核抗体检测的临床意义

The Clinical Significance of Detecting Nonthyroid Specific Antibodies in Patients with Graves' Diseases

目的了解Graves病(GD)甲状腺功能亢进(甲亢)患者免疫球蛋白的水平和抗核抗体(ANA)的阳性率,探讨GD甲亢与其他自身免疫性疾病的关系。方法选取145例GD甲亢患者和45例健康对照者测定其游离甲状腺功能、甲状腺特异性抗体、免疫球蛋白及ANA,并以ANA>1:80分为ANA阳性组及阴性组,比较各组间相关指标的差异。结果病例组ANA阳性率(28.28%)及IgG[(70.96±26.14)mmol/L]水平高于对照组[4.55%,(60.41±11.01)mmol/L)],差别有统计学意义(P<0.05)。病例组中ANA阳性组IgG水平[(80.06±45.40)mmol/L]及白细胞减少症发生率(31.71%)均高于ANA阴性组[(68.56±16.21)mmol/L,15.38%],差别有统计学意义(P<0.05)。病例组中9例(6.2%)患者合并全身性自身免疫性疾病(系统性红斑狼疮2例、干燥综合征4例、重症肌无力3例)。结论 GD甲亢ANA阳性者常合并其他全身性自身免疫性疾病,常规检测免疫球蛋白和ANA,对判断免疫损伤的程度、指导免疫治疗和预防复发均有重要意义。

Objective To study the level of immunoglobulin and the prevalence of ANA in patients with Graves＇ diseases（GD）.To explore the correlation between GD and other systemic autoimmune disorders. Methods Data of 145 patients with GD and 45 healthy subjects were collected. All cases were detected on the presence of ANA and the level of immunoglobulin, FT3, FT4, and thyroid specific antibodies. Results The presencerate of ANA and the level of IgG in patients with GD were higher than that in healthy controls [（28.28% vs 4.55% ）; （70.96±26.14 vs 60.41±11.01） mmol/L] （P〈0.05）. The level of IgG and the incidence of leucopenia in patients with ANA positive were higher than those in patients with ANA negative [（80.06±45.40 vs 68.56±16.21） retool/L, （31.71% vs 15.38%）] （P〈0.05）.9（6.2%）cases had systemic autoimmune disorders（2 SLE, 4 SS, 3 myasthenia gravis）. Conclusions Graves＇diseases often accompanies systemic autoimmune disorders. Detecting immunoglobuhn and ANA has a great meaning to judge the severity of immunologic injury, guide immunotherapy and prevent the recurrence of GD.