血清TRAb放免检测在甲状腺疾病诊治中的价值

The Clinical Values of Serum TRAb by RIA in the Diagnosis and Treatment of Thyroid Diseases

对甲状腺疾病患者 (共 758例 ,其中 :初诊甲亢组 166例 ,甲亢内科治疗甲功正常组 198例 ,甲亢内科治疗甲功异常组 86例 ,甲亢内科治疗甲减组 2 4例 ,甲亢 131I治疗甲功正常组 10 4例 ,亚甲炎组 4 8例 ,单纯性甲状腺肿组 52例 ,原发性甲减组 80例 )及 62例正常人的血清 TRAb(促甲状腺激素受体抗体 )浓度进行了放免检则。结果表明 :初诊甲亢组甲亢内科治疗甲功正常组、甲亢内科治疗甲功异常组、甲亢内科治疗甲减组、甲亢 13 1I治疗甲功正常组、原发性甲减组的血清 TRAb明显增高 ,与正常对照组比较 ,P<0 .0 1,有显著性差异 ;亚甲炎组、单纯性甲状腺肿组的血清 TRAb正常 ,与正常对照组比较 ,P>0 .0 5,无显著性差异。甲亢内科治疗甲功正常组的 TRAb均值和阳性率与甲功异常组比较 ,皆 P<0 .0 1,有显著性差异 ;甲亢内科治疗甲功正常组 TRAb均值和阳性率与甲亢 13 1I治疗甲功正常组比较 ,皆 P<0 .0 1,有显著性差异。由此可见 ,甲亢和原发性甲减患者血清 TRAb浓度普遍升高 ,亚甲炎、单纯性甲状腺肿患者血清 TRAb浓度不升高。因此 TRAb的放免检测可认为是甲亢、甲减的辅助诊断指标 ,也是甲亢和亚甲炎的鉴别诊断指标 ;同时 ,TRAb是评价机体自身免疫监护功能的重要指标 ,也是停用甲状腺药物的一项指标。

The TRAb content of the thyroid diseases 758 cases (including the first visit thyroidism group 166 cases; the thyroidism group with normal thyroid function by mesicine treatment 198 cases, the group with abnormal thyroid function by medicine treatment 86 cases, the group with lower thyroid function 24 cases, the group with normal thyroid function by 131 I treatmnt 104 cases, the subacute thyroiditis group 48 cases, the simple goiter group 52 cases, the primary hypothyroidism group 80 cases) and the normal control group 62 cases are detected. The results show that the values of TRAb are much higher in the groups with normal or abnormal thyroid function by medicine treatment, the group with lower thyroid function, the group with 131 I treatment and the group with primary hypothyoidism than that of control group ( P <0.01). The values of TRAb are normal in the groups with subacute thyroiditis and simple goiter compared with control group ( P >0.05). The differential of the TRAb average and positive rate is obvious between the groups with normal and abnormal thyroid function by medicine treatment ( P <0.01), as well as between the groups the normal thyroid function by medicine and 131 I treatment ( P <0.01). The TRAb levels in serum are higher in the patients with thyroidism and primary hypo thyroidism, and the TRAb levels are normal in the patients with subacute thyroiditis and simple goiter. So, TRAb is a auxiliary index in the diagnosis of thyroidism and hypo thyroidism and also a differential diagnosis index about the thyroidism and subacute thyroiditis. At the same time, TRAb is an important index in evaluating the autoimmune monitoring function of the body, and stopping the use of thyroid medicine.