【摘要】 目的探讨碘摄入量、促甲状腺激素受体抗体(TRAb)在Graves病(GD)发病及临床转归中的重要意义。方法选择我院2014年1月~2015年1月所接诊的GD甲亢89例(GD组),其他原因起引的甲亢患者80例(其余甲亢组)。观察两组患者游离三碘甲状腺原氨酸3(FT3)、游离甲状腺素4(FT4)、促甲状腺激素(TSH)、促甲状腺激素受体抗体(TRAb)、甲状腺过氧化物酶抗体(TPO-Ab)、甲状腺球蛋白抗体(TG-Ab)水平。对甲亢患者进行1.5年的随访,并对其进行碘摄入量的指导,观察FT3、FT4、TSH、TRAb、TPO-Ab、TG-Ab水平及甲状腺体积改变。结果在对89例GD组随访中,共有40例得到完整随访,并对其进行碘摄入量的指导,其中22例患者甲状腺功能恢复正常,TRAb连续二次测定为阴性,甲状腺体积明显缩小,TPO-Ab、TG-Ab水平基本正常;在对其余甲亢组80例随访中,共有36例得到完整随访,并对其进行碘摄入量的指导,其中20例患者甲状腺功能恢复正常,其余16例患者甲状腺功能未得到显著改善,TRAb一直为阴性,甲状腺体积稍有缩小,TPO-Ab、TG-Ab水平仍较高;相关性分析中,GD甲亢患者TRAb与FT4、FT3、甲状腺体积均呈现正相关。结论碘摄入量、TRAb在GD发病及临床转归中具有重要意义,可为今后临床治疗提供参考依据。更多还原

【Abstract】 Objective To study the significance of iodine intake and TRAb(thyrotrophin receptor antibody) in the pathogenesis and clinical outcome of Graves(GD) disease.Methods 89 patients GD hyperthyroidism from January 2014 to January 2015 in our hospital were selected,80 cases of the rest hyperthyroidism group.the free thyroxine index 3(FT3),FT4,thyrotropin,thyroid stimulating hormone(TSH),TRAb,thyroid peroxidase antibody(TPO-Ab),thyroglobulin antibody( TG- Ab) were compared in two groups. The follow- up for 1. 5 years of GD patients with hyperthyroidism,and the guidance of the iodine intake,the changes of FT4,FT3,TSH,TRAb,TPO-Ab,TG-Ab levels and thyroid volume were observed. Results In the follow- up of 89 patients with GD group, a total of 40 patients were followed up,and the guidance of the iodine intake, the thyroid function of 22 patients returned to normal, TRAb was negative for two consecutive times, and the thyroid volume was significantly reduced, the level of TG- Ab and TPO- Ab was basically normal;a total of 36 patients were followed up for the rest of the 80 patients with hyperthyroidism,and to guide the iodine intake,in which 20 cases of patients with thyroid function returned to normal,thyroid function was not significantly improved in the remaining 16 patients,TRAb has been negative,and the thyroid gland was slightly smaller,TPO-Ab,TG-Ab level was still higher.In the correlation analysis,GD hyperthyroidism patients for the TRAb were positively correlated with TSH,FT3,TRAB,FT4,thyroid volume.Conclusion Iodine intake,TRAb in the pathogenesis and clinical outcome of GD is of great significance,can provide reference for future clinical treatment.更多还原