甲状腺过氧化物酶抗体和甲状腺球蛋白抗体滴度与Graves病甲状腺功能亢进症手术中腺体残留量的临床研究

A study about the correlation between the serum levels of the influence of thyroid peroxidase antibody and thyroglobulin autoanti-body in patients with hyper-thyroidism and the incidence of the hypothyroidism after subtotal thyroidectomy

目的测定手术治疗前Graves病甲状腺功能亢进症患者血清甲状腺过氧化物酶抗体(TPOAb)和甲状腺球蛋白抗体(TGAb)水平,探讨其在手术治疗后与甲状腺功能减退症发生的关系。方法 2010年1月至2012年5月在我院接受手术治疗的Graves病患者共198例,根据手术治疗前TPOAb、TGAb的检测结果,将198例患者分成3组:双阴组35例,单阳组38例,双阳组125例,比较各组间甲状腺功能减退症的发生率;再将双阳组的125例患者,按TPOAb、TGAb滴度水平的高低分成3组:A组41例,B组54例,C组30例,进一步探讨手术治疗前TPOAb、TGAb滴度水平的高低与甲状腺功能减退症的关系。结果双阳组甲状腺功能减退症发生率明显高于双阴组、单阳组(P<0.05),单阳组甲状腺功能减退症发生率明显高于双阴组(P<0.05)。各组间甲状腺功能减退症发生率差异有统计学意义(P<0.05)。结论 TGAb、TPOAb滴度水平的高低,对于甲状腺功能亢进症手术治疗后甲状腺功能减退症的预测有指导作用,可指导Graves病患者术中甲状腺腺体保留量,减少术后甲状腺功能减退症与复发有积极重要意义。

Objective To investigate the correlation between the serum levels of thyroid peroxidase antibody （TPOAb） and thyrog lobulin antibody（TGAb） of patients with hyperthyroidism before surgery therapy and the incidence of the hypothyroidism after surgery intervention. Methods From January 2010 to May 2012 in Graves disease totaling 198 person-times of surgery treatment, by negative or positive results of TPOAb and TGAb, 198 patients with hyper-thyroidism were divided into groups of negative TPOAb and TGAb （n=35）, positive TPOAb and TGAb （n=38） and positive both TPOAb and TGAb （n=125）, and the incidence of hypothyroidism was compared among the three groups after therapy. Further, the 125 cases with positive TPOAb and TGAb were subdivided into three groups by level of TPOAb and TGAb, group A （n=41）, B （n=54） and C （n=30）, for examing the relationship of the levels of TPOAb and TGAb before undergoing treatment of early hypothyroidism. Results Incidence of hypothyroidism of positive both TPOAb and TGAb was obviously higher than that of negative TPOAb and TGAb group, positive TPOAb and TGAb group （P〈0.05）, the incidence of hypothyroidism of positive TPOAb and TGAb group was obviously higher than that of the negative TPOAb and TGAb group（P〈0.05）. And the similar results were found in the 3 sub-groups（P〈0.05）. Conclusion TGAb, TPOAb drop the level of degree of surgical treatment hyperthyroidism for hypothyroidism prediction has a guiding role , after obser-vation above index can guide the Graves disease of thyroid gland reserve volume , reduce the recurrence of postoperative hypothyroidism and have a positive significance.