【摘要】 目的 :研究自身免疫性甲状腺疾病 (Autoimmunethyroiddisease ,AITD)甲状腺自身抗体的临床特点及其在AITD中的致病作用 ,寻找AITD特征性的诊断指标。方法 :运用放免法测定 77例Graves病 (Graves’disease ,GD)甲亢期、39例桥本甲状腺炎 (Hashimoto’sthyroiditis,HT)甲减期患者及 39例正常人的甲状腺球蛋白 (TG)、反三碘甲腺原氨酸 (rT3 )、游离三碘甲腺原氨酸 (FT3 )、游离甲状腺素 (FT4)、超敏促甲状腺激素 (s TSH)、甲状腺球蛋白抗体 (TGAb)、甲状腺过氧化物酶抗体 (TPOAb)、促甲状腺激素受体抗体 (TRAb) ,分析各种抗体的临床特点以及与临床指标间的关系。结果 :AITD组 (包括HT和GD)中TPOAb的阳性率明显高于TGAb和TRAb的阳性率 (P <0 0 5 )。GD甲亢组患者TRAb的滴度及阳性率明显高于HT甲减组患者 (P <0 0 0 1) ,而TGAb、TPOAb的滴度及阳性率明显低于HT甲减组 (P <0 0 1)。HT甲减期患者的TGAb、TPOAb ,尤其是TPOAb与FT3 存在显著负相关 (r =- 0 334,P <0 0 5 ,r=- 0 5 2 0 ,P<0 0 5 )。GD甲亢期患者的TRAb与FT3 之间存在显著正相关 (r=0 4 2 4 ,P <0 0 5 )。结论 :TPOAb可以作为AITD特征性的诊断指标。TRAb在GD的致病中起重要作用 ,而TGAb、TPOAb尤其是TPOAb在HT的致病中起重要作用。更多还原

【Abstract】 Objective:To study the clinical feature and pathogenesis of thyroid autoantibodies in autoimmune thyroid disease, and to search the characteristic diagnostic index for AITD. Methods: Serum TG, rT 3, FT 3, FT 4, s-TSH, TGAb, TPOAb and TRAb were determined by radioimmunoassay in 77 patients with Graves’ disease in hyperthyroidism, with 39 patients of Hashimoto’s thyroiditis in hypothyroidism and 39 normal controls.The clinical feature of thyroid antibodies and the relation between thyroid antibodies and clinical indexes were analyzed. Results: The positive rate of TGAb and TPOAb,especially TPOAb, were significantly higher than that of TRAb in AITD(including GD and HT). There was inverse correlation between the titer of TGAb, TPOAb, especially TPOAb and FT 3 in Hashimoto’s thyroiditis(r=-0.334, P<0.05,r=-0.520, P<0.05).There was positive correlation between the titer of TRAb and FT 3 in Graves’ disease in hyperthyroidism(r=0.424, P<0.05). Conclusions: TPOAb can be used as characteristically diagnostic marker of screening for AITD. TRAb played an important role in the pathogenesis of Graves’ disease. However, TGAb and TPOAb,especially TPOAb, played a more important role than TRAb in the pathogenesis of Hashimoto’s thyroiditis.更多还原