原发性甲亢自身抗体测定与术后临床转归的关系

RELATIONSHIP BETWEEN AUTOANTIBODY AND CLINICAL PROGNOSIS FOR PRIMARY HYPERTHYROIDISM

目的 探讨原发性甲亢患者手术前后自身抗体及细胞学的变化与术后甲状腺功能的关系。方法 对３０ 例原发甲亢患者，术前测定甲状腺激素及抗甲状腺球蛋白抗体（ＴＧＡ） 、抗甲状腺微粒体抗体（ＴＭＡ） ，观察甲状腺内淋巴细胞浸润程度。术后随访１ 年，再次测定，甲状腺功能未恢复正常者用针吸活组织检查法对残留甲状腺行淋巴细胞浸润程度分析。结果 术前，１０ 例患者出现明显淋巴细胞浸润及ＴＧＡ、ＴＭＡ 明显升高，１６ 例仅出现淋巴细胞浸润，ＴＧＡ、ＴＭＡ 无明显升高，其余未见明显淋巴细胞及抗体变化。术后１ 年，２３ 例甲状腺功能恢复正常，３例复发，４ 例甲状腺功能减退，其中５ 例ＴＧＡ、ＴＭＡ 仍为阳性，细胞学检查有明显的淋巴细胞浸润。结论 原发性甲亢患者术后甲状腺功能状态与自身抗体的变化及淋巴细胞浸润程度明显相关。

ObjectiveTo investigate the relationship between pre-and post-operative autoantibody , cellulous changes and postoperative thyroid function for primary hyperthyroid patients. MethodsMeasurement of serum thyroxine ,autoantibody(TGA,TMA) and analysis of lymphocyte infiltration degree in thyroid glands were performed in thirty patients with hyperthyroidism.Followed up for one year after operation,these patients were monitored of the above parameters again, infiltration degree of lymphocyte in the remnant of thyroid glands were analysed with needle biopsy for malfunction patients. ResultsBefore operation, significant infiltration of lymphocyte and increase of TGA,TMA were observed in 10 patients, while only infiltration of lymphocyte in 16 patients, there were no significant changes of the above parameters in the rest.One year after operation, twenty-three patients recovered, three reoccurred with hyperthyroidism ,four occurred with hypothyroidism.There were TGA,TMA positive expression and significant infiltration of lymphocyte in five patients with thyroid malfunction. ConclusionThe relationship between postoperative thyroid function and changes of autoantibody as well as infiltration degree of lymphocyte is very close for primary hyperthyroidism.