Graves病患者^(131)I治疗前后TRAb、TGA和TMA的变化及其与早发甲减的关系

Changes of Serum TRAb,TGA and TMA Concentrations in Graves' Patients Treated with ^(131)I and the Rate of Early Hypothyroidism

目的:测定Graves病患者131I治疗前后血清TRAb、TGA、TMA水平,探讨其变化规律及与早发甲减的关系。方法:收集215例经131I治疗的Graves病患者,根据临床症状和实验室检查结果分为治愈组和早发甲减组,应用化学发光免疫分析测定患者治疗前3个月,治疗后3、6、12、18个月血清TRAb、TGA、TMA的含量,并进行比较。结果:131I治疗后3个月血清TRAb含量明显升高(P<0.05),TGA、TMA值与治疗前无明显差异(P>0.05)。治疗后6个月TRAb达最高值并呈下降趋势,TGA、TMA值明显升高。治疗后12个月TRAb、TGA、TMA值明显下降,治疗后18个月各项指标均接近正常。治愈组患者TRAb阳性率显著地低于其他组(P<0.05),早发甲减组患者TGA、TMA阳性率显著地高于其他组(P<0.05)。结论:动态监测Graves病患者131I治疗前后血清TRAb、TGA、TMA的含量,对Graves病的疗效观察、预后判断及早发甲减的预后评估具有重要的意义。因此,这些实验项目对Graves病而言,应置于优先的考虑。

Objective To study the relationship between changes of serum TRAb,TGA,TMA levels and the rate of early hypothy-roidism in patients with Graves＇ disease treated with ,311. Methods The serum TRAb, TGA, TMA concentrations were measured 3 months before treatment and 3,6, 12 and 18 months after therapy in 215 Graves＇ patients with chemiluminescence immunoassay （CLIA）. These patients were divided into cure group and early hypothyroidism group according to the clinical symptoms and laboratory test results. Results After 3 months of treated with 131 I, the serum TRAb level was significantly increased （ P 〉 0.05 ）, TGA, TMA levels in patients were minor difference form before treatment（P 〈0.05）. 6 months after treatment TRAb reached the highest value and a downward trend, TGA,TMA were distinctly increasedo 12 months after treatment TRAb, TGA, TMA significantly decreased, after treatment for 18 months all targets were near normal. The positive rate of serum TRAb in cure patients was absolutely lower than anoth- er groups （P 〉 0.05 ）. The positive rates of serum TGA, TMA in early hypothyroidism patients were obviously higher than another groups （ P 〉 0.05 ）. Conclusion There is very important clinical significance for the Graves＇ patients to accept the developmental observation of serum TRAb,TGA and TMA concentrations both before and after t3tI Therapy,which provides a great of positive information for observation therapeutic effects, prognosis judgement and to evaluate the prognosis early hypothyroidism. Thereby, these laboratory items should place priority on Graves＇ disease.