Schneidinger P, Joller-Jemelka H, Grob P J
Schweiz Med Wochenschr. 1985 Nov 2;115(44):1536-44.
Using commercially available test kits, thyroid-stimulating immunoglobulin (TSIg), microsomal thryoid antibodies (MAK) und antibodies against thyroglobulin (TAK) were measured in sera of 201 patients. Over 13% inhibition of TSH-binding to TSH receptor (TSIg) was found in 18 of 25 (72%) patients with hyperthyroid Graves' disease, in 18 of 61 (30) patients with Graves' disease who have become euthyroid, in 4 of 33 (15%) patients with autoimmune thyroiditis, in one of 20 patients with hyperthyroid multinodular goitre or with iodine-induced hyperthyroidism, and in 2 of 55 patients with nontoxic goitre but in none of 7 patients with congenital hyperthyroidism. When further subdividing the patients with Graves' disease who were euthyroid, TSIg values were abnormal in 47% of the patients still under treatment and in 20% of those in remission without treatment. The simultaneous presence of MAK and TAK was most often found in patients with autoimmune thyroiditis, less frequently in patients with Graves' disease and never in patients with other thyroid disorders. MAK and TAK were only detectable in patients with Graves' disease who also had TSIg. The diagnostic, prognostic and follow-up value of the three antibodies is discussed.
使用市售检测试剂盒,对201例患者血清中的促甲状腺素免疫球蛋白(TSIg)、微粒体甲状腺抗体(MAK)和抗甲状腺球蛋白抗体(TAK)进行了检测。在25例(72%)甲状腺功能亢进型格雷夫斯病患者中,有18例(13%以上)出现促甲状腺激素(TSH)与TSH受体(TSIg)结合受到抑制;在61例甲状腺功能已恢复正常的格雷夫斯病患者中,有18例(30%)出现这种情况;在33例自身免疫性甲状腺炎患者中,有4例(15%)出现这种情况;在20例甲状腺功能亢进型多结节性甲状腺肿或碘致甲状腺功能亢进患者中,有1例出现这种情况;在55例非毒性甲状腺肿患者中,有2例出现这种情况;而在7例先天性甲状腺功能亢进患者中均未出现这种情况。在进一步细分甲状腺功能已恢复正常的格雷夫斯病患者时发现,仍在接受治疗的患者中有47%的TSIg值异常,未经治疗而处于缓解期的患者中有20%的TSIg值异常。MAK和TAK同时出现的情况最常见于自身免疫性甲状腺炎患者,较少见于格雷夫斯病患者,在其他甲状腺疾病患者中从未出现。MAK和TAK仅在同时伴有TSIg的格雷夫斯病患者中可检测到。文中讨论了这三种抗体的诊断、预后和随访价值。