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[甲巯咪唑治疗免疫性甲状腺功能亢进患者中促甲状腺激素结合抑制性免疫球蛋白(TBII)测定的临床相关性]

[Clinical relevance of the determination of TSH-binding inhibitory immunoglobulins (TBII) in patients with immunogenic hyperthyroidism in methimazole therapy].

作者信息

Heberling H J, Bierwolf B, Kuhlmann E, Klugmann T, Dietel P, Fischer S

出版信息

Dtsch Z Verdau Stoffwechselkr. 1987;47(6):331-6.

PMID:2896115
Abstract

In 38 patients with immunogenic hyperthyroidism a follow-up was performed to estimate the value of TBII before, during and after methimazole therapy. Before therapy increased TBII were detectable in 37 patients (94.4%). After 12 months methimazole therapy 25 patients had TSH-receptor antibodies (66%) within the normal range. In 13 patients positive antibody titres were found. In most cases persistence of increased TBII-values during drug treatment was an indicator of the persistence of active hyperthyroidism (10 of 13 patients). In the rule a disappearance of TBII-activity was combined with a functional remission (22 of 25 patients). Prolonged demonstration of TBII-activity in conjunction with persistence of hyperthyroidism should lead to ablative measures. In contrast to this medical therapy should be finished in patients with immunological and functional remission. Though in the further follow-up a recurrence of the immunological base of the disease with a functional and clinical relapse is possible.

摘要

对38例免疫性甲状腺功能亢进患者进行了随访,以评估在甲巯咪唑治疗前、治疗期间和治疗后的促甲状腺素受体抗体(TBII)水平。治疗前,37例患者(94.4%)可检测到TBII升高。甲巯咪唑治疗12个月后,25例患者(66%)的促甲状腺素受体抗体在正常范围内。13例患者抗体滴度呈阳性。在大多数情况下,药物治疗期间TBII值持续升高是活动性甲状腺功能亢进持续存在的指标(13例患者中的10例)。通常,TBII活性消失与功能缓解相关(25例患者中的22例)。TBII活性持续显示并伴有甲状腺功能亢进持续存在时,应采取消融措施。与此相反,对于免疫和功能缓解的患者,应停止药物治疗。不过,在进一步随访中,疾病的免疫基础可能会复发并伴有功能和临床复发。

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