甲状腺过氧化物酶抗体阳性与Graves病抗甲状腺药物治疗后的无复发生存相关。
Thyroid Peroxidase Antibody Positivity is Associated With Relapse-Free Survival Following Antithyroid Drug Treatment for Graves Disease.
作者信息
Muir Christopher A, Jones Graham R D, Greenfield Jerry R, Weissberger Andrew, Samaras Katherine
机构信息
From the Department of Endocrinology, St. Vincent's Hospital, Sydney, New South Wales, Australia; University of Sydney, Sydney, New South Wales, Australia.
SydPath, St. Vincent's Hospital, Sydney, New South Wales, Australia; St. Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
出版信息
Endocr Pract. 2020 Sep;26(9):1026-1030. doi: 10.4158/EP-2020-0035.
OBJECTIVE
Graves' disease is an autoimmune disease characterized by production of autoantibodies directed against the thyroid gland. Thyrotropin-receptor antibodies (TRAbs) are clearly pathogenic, but the role of thyroidperoxidase antibodies (TPOAbs) in Graves disease is unknown.
METHODS
We retrospectively studied whether TPOAb positivity reduced risk of relapse following antithyroid drug (ATD) treatment in newly diagnosed Graves disease.
RESULTS
During follow-up of 204 patients with TRAb-positive Graves disease, 107 (52%) relapsed following withdrawal of ATD. Mean age was 40.0 years, and 82% were female. The average duration of ATD treatment was 23.5 months and was not different between patients who relapsed and those with sustained remission. Absence of TPOAbs significantly increased risk of Graves relapse (odds ratio, 2.21). Male sex and younger age were other factors significantly associated with increased risk of relapse.
CONCLUSION
TPOAb positivity significantly improves the odds of remission following ATD treatment in newly diagnosed Graves' disease.
目的
格雷夫斯病是一种自身免疫性疾病，其特征是产生针对甲状腺的自身抗体。促甲状腺素受体抗体（TRAbs）具有明确的致病性，但甲状腺过氧化物酶抗体（TPOAbs）在格雷夫斯病中的作用尚不清楚。
方法
我们回顾性研究了TPOAb阳性是否会降低新诊断的格雷夫斯病患者抗甲状腺药物（ATD）治疗后复发的风险。
结果
在对204例TRAb阳性的格雷夫斯病患者的随访中，107例（52%）在停用ATD后复发。平均年龄为40.0岁，82%为女性。ATD治疗的平均持续时间为23.5个月，复发患者和持续缓解患者之间无差异。TPOAbs阴性显著增加了格雷夫斯病复发的风险（比值比，2.21）。男性和年轻是与复发风险增加显著相关的其他因素。
结论
TPOAb阳性显著提高了新诊断的格雷夫斯病患者ATD治疗后缓解的几率。
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