Wuttke H
Fortschr Med. 1978 Dec 7;96(46):2325-8.
Thyroid antibodies and thyroid-stimulating factors (LATS and LATS-Protector) have been controlled 53 patients with Graves' disease during antithyroid drug treatment. It has been demonstrated that dosage is higher and duration of treatment has been more protracted in antibody-positive thyrotoxicosis than in patients without these antibodies. Thyroid antibodis have been found only in patients with detectable thyroid-stimulating factors, which are identified as immunglobulins. These results indicate the importance of immunologic processes. Suppressibility of thyroid function proved 2 months after stopping medical treatment, was negative in 19 and positive in 17 patients. Thyroid-stimulating factors remained positive up to this time in 20 patients and disappeared in 18. In 8 patients the suppression-test was positive indicating a normal function of the thyroid stimulating hormone (TSH), but thyroid-stimulating factors still have been detected in these patients. These results are controversial to the autoimmune-concept of the pathogenesis of Graves' disease. As this concept cannot be refused, changes in the effectivity of LATS or LATS protector by crude serum factors or by changes of the receptor structures are discussed.
在抗甲状腺药物治疗期间，对53例格雷夫斯病患者的甲状腺抗体和甲状腺刺激因子（长效甲状腺刺激素和长效甲状腺刺激素保护因子）进行了监测。结果表明，抗体阳性的甲状腺毒症患者所需药物剂量更高，治疗持续时间更长。仅在可检测到甲状腺刺激因子（被鉴定为免疫球蛋白）的患者中发现了甲状腺抗体。这些结果表明免疫过程的重要性。停药2个月后，甲状腺功能抑制试验结果显示，19例患者为阴性，17例患者为阳性。此时，20例患者的甲状腺刺激因子仍为阳性，18例患者的甲状腺刺激因子消失。8例患者的抑制试验呈阳性，表明促甲状腺激素（TSH）功能正常，但这些患者仍检测到甲状腺刺激因子。这些结果与格雷夫斯病发病机制的自身免疫概念存在争议。由于这一概念不能被否定，因此讨论了粗血清因子或受体结构变化对长效甲状腺刺激素或长效甲状腺刺激素保护因子有效性的影响。
