[促甲状腺素受体抗体（TRAb）作为格雷夫斯-巴塞多氏病手术治疗效果的一项检测指标]

[Thyrotropin receptor antibodies (TRAb) as a test of surgical treatment effectiveness in Graves-Basedow's diseases].

作者信息

Bojarska-Szmygin Anna, Ciechanek Roman, Jezierska Beata, Zaorska-Rajca Janina

机构信息

Pracownia Medycyny Nuklearnej, Oddział Chirurgii Ogólnej, Zakład Diagnostyki Radiologicznej Wojewódzkiego Szpitala Specjalistycznego im. Kardynała Stefana Wyszyńskiego w Lublinie.

出版信息

Pol Merkur Lekarski. 2002 Sep;13(75):196-9.

PMID:12474569

Abstract

The aim of the study was to assess the relations between the concentration of antibodies against TSH receptors (TRAb) and the outcome of the surgical treatment in Graves-Basedow's disease. The studies were performed in 30 patients (age range--18-50, mean -37) operated on for Graves-Basedow's disease and in 20 healthy controls. In control group, the TRAb concentration was mean -2.75 +/- 2.06 U/l, the TSH mean -1.06 +/- 0.53 mlU/l, and FT4 mean -14.71 +/- 2.15 pmol/l. The thyroid volume was mean -14.45 +/- 2.37 ml. In the group operated on antibody concentration was determined before and 12 months after the surgery. The TSH and FT4 concentrations were also determined before and 12 months after the operation. Moreover, the size of the thyroid remnant was assessed ultrasonographically 12 months after the procedure. The results showed the effectiveness of the surgical treatment, i.e. hyperthyroidism was not observed in 22 out of 30 patients. Among these 22 patients, euthyreosis was found in 14 cases (46%) and hypothyreosis was observed in 8 cases (27%). In the euthyreosis group, the pre-operative TRAb concentration was mean -24.00 +/- 11.04 U/l. 12 months after the operation, the decreased levels of antibodies were found in 13 patients (mean -6.14 +/- 5.71 U/l). In the hypothyreosis group, the pre-operative TRAb concentration was mean -24.50 +/- 10.43 U/l. After the surgical procedure, TRAb levels were normal in all patients, the average values being 2.13 +/- 1.34 U/l. In 8 patients with recurrent hyperthyroidism (27%), TRAb concentration before the surgery was higher, mean -107.25 +/- 56.69 U/l. 12 months after subtotal strumectomy, the patients in this group still did not show normal TRAb levels (mean -54.25 +/- 51.61 U/l). Moreover, the relations between the size of the thyroid remnant and the TRAb level were evaluated. In the group with recurrent hyperthyroidism and high TRAb levels, the thyroid size (volume) left was mean -12.10 +/- 6.25 ml, in the euthyreosis group mean -5.54 +/- 2.23 ml, while in the hypothyreosis group it was mean -4.86 +/- 1.14 ml.

摘要

该研究的目的是评估促甲状腺激素受体抗体（TRAb）浓度与Graves病手术治疗结果之间的关系。研究对象为30例接受Graves病手术治疗的患者（年龄范围18 - 50岁，平均37岁）以及20名健康对照者。对照组中，TRAb浓度平均为2.75±2.06 U/l，促甲状腺激素（TSH）平均为1.06±0.53 mIU/l，游离甲状腺素（FT4）平均为14.71±2.15 pmol/l。甲状腺体积平均为14.45±2.37 ml。对手术组患者在手术前和术后12个月测定抗体浓度，同时在手术前和术后12个月测定TSH和FT4浓度。此外，术后12个月通过超声评估甲状腺残余组织的大小。结果显示了手术治疗的有效性，即30例患者中有22例未出现甲状腺功能亢进。在这22例患者中，14例（46%）甲状腺功能正常，8例（27%）出现甲状腺功能减退。在甲状腺功能正常组中，术前TRAb浓度平均为24.00±11.04 U/l。术后12个月，13例患者（平均6.14±5.71 U/l）的抗体水平下降。在甲状腺功能减退组中，术前TRAb浓度平均为24.50±10.43 U/l。手术后，所有患者的TRAb水平均正常，平均值为2.13±1.34 U/l。在8例复发甲状腺功能亢进的患者（27%）中，手术前TRAb浓度较高，平均为107.25±56.69 U/l。甲状腺次全切除术后12个月，该组患者的TRAb水平仍未恢复正常（平均54.25±51.61 U/l）。此外，还评估了甲状腺残余组织大小与TRAb水平之间的关系。在复发甲状腺功能亢进且TRAb水平较高的组中，剩余甲状腺大小（体积）平均为12.10±6.25 ml，甲状腺功能正常组平均为5.54±2.23 ml，而甲状腺功能减退组平均为4.86±1.14 ml。