Marcocci C, Chiovato L, Mariotti S, Pinchera A
J Endocrinol Invest. 1982 Jan-Feb;5(1):13-9. doi: 10.1007/BF03350476.
The changes occurring in the levels of circulating thyroid microsomal antibody (M-Ab) and antithyroglobulin antibody (Tg-Ab) during antithyroid drug therapy were studied in 32 patients receiving methimazole for Graves' disease. M-Ab was determined by competitive binding radioassay and Tg-Ab by a sandwich radiometric method. Before treatment 25 subjects (78.1%) had abnormally elevated (greater than or equal to 75 U/ml) M-Ab levels. A more than 30% reduction of M-Ab concentration with respect to the pretreatment value was found in 16 (64.0%) of these patients within the first 3-5 months of therapy, in 23 (92.0%) within 8-11 months and in 21 (84.0%) at the end of treatment (16-18 months). No change was found in the 7 patients with initial M-Ab levels less than 75 U/ml. The reduction of M-Ab was more pronounced in the patients with good control of thyrotoxicosis than in those who were still hyperthyroid or were rendered hypothyroid during treatment. Twenty-three patients were followed after completion of the course of methimazole therapy, and 13 of them showed relapse of hyperthyroidism. A significant rise of M-Ab with respect to the values observed at the end of treatment occurred in all relapsing patients who had abnormally elevated M-Ab levels before therapy. With one exception, no M-Ab increase was found in the 10 nonrelapsing patients. However, no difference between relapsing and nonrelapsing patients was observed when the M-Ab changes occurring during treatment were considered. A similar trend during and after withdrawal of therapy was noted for Tg-Ab but, because of the relatively small percentage of positive subjects (25%), the results were less conclusive. The present data indicate that methimazole treatment induces a fall of thyroid antibodies in patients with Graves' disease, and that relapse of hyperthyroidism is associated with an increase of these antibodies. However, the antibody changes occurring during treatment showed no prognostic value in predicting the outcome of therapy.
对32例接受甲巯咪唑治疗格雷夫斯病的患者，研究了抗甲状腺药物治疗期间循环甲状腺微粒体抗体（M-Ab）和抗甲状腺球蛋白抗体（Tg-Ab）水平的变化。M-Ab采用竞争性结合放射分析法测定，Tg-Ab采用夹心放射测量法测定。治疗前，25例受试者（78.1%）的M-Ab水平异常升高（大于或等于75 U/ml）。在治疗的前3至5个月内，这些患者中有16例（64.0%）的M-Ab浓度相对于治疗前值降低了30%以上；8至11个月内有23例（92.0%）；治疗结束时（16至18个月）有21例（84.0%）。最初M-Ab水平低于75 U/ml的7例患者未发现变化。甲状腺毒症得到良好控制的患者中M-Ab的降低比治疗期间仍为甲状腺功能亢进或发生甲状腺功能减退的患者更为明显。23例患者在完成甲巯咪唑治疗疗程后接受随访，其中13例出现甲状腺功能亢进复发。所有治疗前M-Ab水平异常升高的复发患者，其M-Ab相对于治疗结束时观察到的值均显著升高。除1例例外，10例未复发患者未发现M-Ab升高。然而，考虑治疗期间发生的M-Ab变化时，复发患者和未复发患者之间未观察到差异。Tg-Ab在治疗期间和停药后也呈现类似趋势，但由于阳性受试者的比例相对较小（25%），结果的结论性较差。目前的数据表明，甲巯咪唑治疗可使格雷夫斯病患者的甲状腺抗体下降，甲状腺功能亢进复发与这些抗体的增加有关。然而，治疗期间发生的抗体变化在预测治疗结果方面没有预后价值。
