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[格雷夫斯病患者甲状腺次全切除术前、后血清促甲状腺素结合抑制性免疫球蛋白(TBII)活性]

[Serum thyrotropin binding inhibitory immunoglobulin (TBII) activity before and after subtotal thyroidectomy in Grave's disease].

作者信息

Hoshi T, Watanabe I, Endo S

出版信息

Nihon Geka Gakkai Zasshi. 1985 Nov;86(11):1538-45.

PMID:2867461
Abstract

Serum level of TBII activity was measured in 81 patients with Graves' disease by the Smith's radioreceptor assay method and the activity more than +15% was designated as "positive". All the patients had been under medical treatment with antithyroid drugs and 71 of them underwent subtotal thyroidectomy. The negative TBII activity was seen in 4 (22%) of 18 patients in whom the duration of antithyroid drug treatment was less than 2 years and in 6 (60%) of 10 patients whose medical therapy was for more than 2 years. TBII activity was not correlated with serum MCHA-, TGHA-titers and circulating lymphocyte counts, but correlated well with the degree of lymphoid cell infiltration in the resected thyroid tissue. All the 7 patients was negative had never relapsed, but 2 of them remained at the euthyroid state 6 to 24 months after operation, 3 hypothyroid and 2 at a borderline between the normal and hypothyroid. The postoperative states of the 13 patients who showed positive TBII activity before operation were euthyroid in 7, hypothyroid in 2, borderline hypothyroid in 4 and relapse in one. A gradual decline of TBII activity following surgery was generally associated with postoperative euthyroidism. It is concluded that determination of TBII activity is of help to estimate the thyroid functional state in Graves' disease.

摘要

采用史密斯放射受体分析法测定了81例格雷夫斯病患者的血清TBII活性水平,活性超过+15%被定为“阳性”。所有患者均接受抗甲状腺药物治疗,其中71例行甲状腺次全切除术。在18例抗甲状腺药物治疗时间少于2年的患者中,有4例(22%)TBII活性为阴性;在10例药物治疗超过2年的患者中,有6例(60%)TBII活性为阴性。TBII活性与血清MCHA-、TGHA滴度及循环淋巴细胞计数无关,但与切除甲状腺组织中淋巴细胞浸润程度密切相关。所有7例TBII活性为阴性的患者均未复发,但其中2例术后6至24个月处于甲状腺功能正常状态,3例为甲状腺功能减退,2例处于正常与甲状腺功能减退之间的临界状态。术前TBII活性为阳性的13例患者术后状态为:7例甲状腺功能正常,2例甲状腺功能减退,4例临界甲状腺功能减退,1例复发。术后TBII活性逐渐下降通常与术后甲状腺功能正常有关。结论是,测定TBII活性有助于评估格雷夫斯病患者的甲状腺功能状态。

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