Gamstedt A, Wadman B, Karlsson A
J Clin Endocrinol Metab. 1986 Apr;62(4):773-7. doi: 10.1210/jcem-62-4-773.
The effects of methimazole or betamethasone therapy on the TSH receptor antibody response to radioiodine therapy were compared in a prospective randomized study of 60 patients with hyperthyroidism due to Graves' disease. The patients were followed for 1 yr after treatment with 131I. Twenty-three patients received 131I alone, 17 were treated with methimazole for 2 months before and 3 months after 131I therapy, and 20 patients were treated with betamethasone for 3 weeks before and 4 weeks after 131I therapy. 131I induced a transient rise in the mean serum level of TSH receptor autoantibodies, measured as TSH binding inhibitory immunoglobulin (TBII), but in patients receiving methimazole treatment, no such rise occurred. In the betamethasone-treated patients, TBII increased similarly to that in patients treated with 131I alone. In addition, in patients given betamethasone, there was an early decrease in total serum immunoglobulin G, which persisted throughout the follow-up period. In the other 2 groups, no changes in total immunoglobulin G were found. The results demonstrate that in hyperthyroid Graves' disease, TBII production is influenced by therapy. Methimazole abolished the 131I-induced increase in TBII, whereas betamethasone did not have such an inhibitory effect.
在一项针对60例格雷夫斯病所致甲状腺功能亢进患者的前瞻性随机研究中，比较了甲巯咪唑或倍他米松治疗对促甲状腺激素（TSH）受体抗体对放射性碘治疗反应的影响。患者接受131I治疗后随访1年。23例患者仅接受131I治疗，17例在131I治疗前2个月及治疗后3个月接受甲巯咪唑治疗，20例在131I治疗前3周及治疗后4周接受倍他米松治疗。131I可使促甲状腺激素受体自身抗体的平均血清水平出现短暂升高，以促甲状腺激素结合抑制免疫球蛋白（TBII）衡量，但接受甲巯咪唑治疗的患者未出现这种升高。在接受倍他米松治疗的患者中，TBII的升高与仅接受131I治疗的患者相似。此外，接受倍他米松治疗的患者血清总免疫球蛋白G早期下降，并在整个随访期持续存在。在其他两组中，未发现血清总免疫球蛋白G有变化。结果表明，在甲状腺功能亢进的格雷夫斯病中，TBII的产生受治疗影响。甲巯咪唑消除了131I诱导的TBII升高，而倍他米松没有这种抑制作用。
