治疗后甲状腺功能正常的Graves病患者TRAb对TSH水平的抑制效应

Influence of TRAb on TSH in treated euthyroid patients with Graves disease

目的观察Graves病患者治疗中促甲状腺素受体抗体(thyrotrophin receptor antibody,TRAb)和促甲状腺素(thyroid-stimulating hormone,TSH)水平的变化,探讨TRAb对TSH水平是否有抑制作用。方法91例Graves病患者服用丙硫嘧啶(Propylthiouracil,PTU)治疗,甲状腺功能正常至少2个月以上,其中44例TSH水平仍较低,47例TSH水平正常,比较两组之间的TRAb水平变化。结果两组间FT3、FT4水平无差异,低TSH组与TSH正常组相比较,TRAb水平明显升高(P<0.0),且TRAb水平与TSH水平呈显著负相关(r=-0.374,P<0.001)。结论治疗后甲状腺激素水平正常的Graves病部分患者的低TSH水平可能是由于高TRAb水平的抑制效应。

Objective To investigate the change in levels of TRAb and TSH in patients with Graves disease, and to examine whether TRAb has inhibitive effect on TSH. Methods After Propylthiouracil （PTU） treatment, 91 patients with Graves disease became euthyroid for at least 2 months. Among them, 44 patients had low TSH level, while the other 47 had normal TSH level. The levels of TRAb between the two groups were compared. Results There were no significant differences in levels of FT3 and PT4 between the groups. The level of TRAb in low TSH level group was significantly higher than that in normal TSH group （ P 〈 0.001 ）, and TRAb levels were negatively correlated with TSH levels （ r =- 0. 374, P 〈 0. 001 ）. Conclusion Thyrotropin suppression in treating euthyriod patients with Graves disease may be attributed to TSH receptor antibody activity.