Finke R, Kotulla P, Wenzel B, Bogner U, Meinhold H, Schleusener H
Dtsch Med Wochenschr. 1981 Jan 9;106(2):38-42. doi: 10.1055/s-2008-1070253.
In 69 hyperthyroid patients with diffuse uptake in the scintigram, thyrotropin displacing antibodies (TDA) were measured before, during and after thyrostatic treatment. In a further 42 patients antibody activity was investigated before and 6-12 weeks after radio-iodine treatment, and in 29 patients it was measured before and after subtotal thyroidectomy. Persistence of demonstrable TDA during and after the end of drug treatment was in all cases indicative of recurrence of hyperthyroidism. On the other hand, disappearance of TDA activity was not a guarantee for prolonged remission as five patients had a recurrence despite loss of TDA activity. In a further nine patients hyperthyroidism reappeared with recurrence of TDA after varyingly long periods of remission. Thyrostatic treatment should be performed until disappearance of antibodies. Prolonged demonstration of TDA should lead to surgical intervention. Besides the usefulness in establishing the diagnosis of immunogenic hyperthyroidism (Graves' disease) TDA estimation may be of some prognostic value in the use of thyrostatics. In contrast, after radio-iodine treatment or operation the functioning capacity of the remaining thyroid tissue seems to be more relevant for the success of treatment than the possibly longer acting antibodies.
在69例闪烁图显示弥漫性摄取的甲状腺功能亢进患者中，在进行抗甲状腺药物治疗前、治疗期间及治疗后均检测了促甲状腺素置换抗体（TDA）。另外42例患者在放射性碘治疗前及治疗后6 - 12周检测了抗体活性，29例患者在甲状腺次全切除术前及术后检测了抗体活性。在药物治疗期间及结束后仍可检测到TDA，在所有病例中均提示甲状腺功能亢进复发。另一方面，TDA活性消失并不能保证长期缓解，因为有5例患者尽管TDA活性消失但仍复发。另有9例患者在不同时间的缓解期后，随着TDA的复发甲状腺功能亢进再次出现。抗甲状腺药物治疗应持续至抗体消失。TDA持续存在时间较长应导致手术干预。除了在诊断免疫性甲状腺功能亢进（格雷夫斯病）方面有用外，TDA检测在抗甲状腺药物的使用中可能具有一定的预后价值。相比之下，在放射性碘治疗或手术后，剩余甲状腺组织的功能状态似乎比可能作用时间更长的抗体对治疗成功更具相关性。
