Cho B Y, Shong Y K, Chung J K, Lee M C, Lee H K, Koh C S, Min H K
Department of Internal Medicine, College of Medicine, Seoul National University, Korea.
Thyroidology. 1989 Dec;1(3):109-14.
We investigated the effect of a single dose of 131I upon thyrotropin receptor antibodies (TRAb) in 21 patients with Graves' disease. The thyrotropin receptor antibodies were assessed by parallel measurements of thyrotropin binding inhibitor immunoglobulin (TBII), thyroid stimulating antibody (TSAb), and thyroid stimulation blocking antibody (TSBAb) in serum by radioreceptor assay, stimulation of adenylate cyclase and inhibition of TSH-stimulated adenylate cyclase activation in FRTL-5 cells, respectively. Prior to radioiodine treatment TBII was detected in all 21 patients and TSAB in 19 patients. After radioiodine treatment TBII activities did not change during 12 months observation period, but in eight patients TSAb activities gradually decreased and were undetectable at the end of a 12 month observation period. Persistence of TSAb was not associated with clinical outcome. Eight patients developed hypothyroidism within 1 year after radioiodine treatment. Three of the hypothyroid patients developed TSBAb, and the appearance of TSBAb coincided with the development of hypothyroidism. These results suggest that TSBAb might develop after radioiodine treatment in a minority of patients with Graves' disease, and that the appearance of TSBAb, in addition to radiation induced thyroid destruction, might be involved in the development of hypothyroidism following radioiodine treatment.
我们研究了单次剂量的¹³¹I对21例格雷夫斯病患者促甲状腺素受体抗体（TRAb）的影响。通过放射受体测定法平行检测血清中的促甲状腺素结合抑制免疫球蛋白（TBII）、甲状腺刺激抗体（TSAb）和甲状腺刺激阻断抗体（TSBAb），分别通过FRTL-5细胞中腺苷酸环化酶的刺激和促甲状腺素刺激的腺苷酸环化酶激活的抑制来评估促甲状腺素受体抗体。在放射性碘治疗前，21例患者均检测到TBII，19例患者检测到TSAB。放射性碘治疗后，在12个月的观察期内TBII活性未发生变化，但8例患者的TSAb活性逐渐降低，在12个月观察期结束时检测不到。TSAb的持续存在与临床结果无关。8例患者在放射性碘治疗后1年内发生甲状腺功能减退。其中3例甲状腺功能减退患者出现了TSBAb，TSBAb的出现与甲状腺功能减退的发生同时出现。这些结果表明，少数格雷夫斯病患者在放射性碘治疗后可能会出现TSBAb，并且TSBAb的出现除了辐射诱导的甲状腺破坏外，可能还参与了放射性碘治疗后甲状腺功能减退的发生。
