Morosini P, Arnaldi G, Taccaliti A, Mancini V, Filipponi S, Giacchetti G, Petrelli M D, Simonella G, Maniscalco L
Clinica di Endocrinologia, Università, Ancona.
Recenti Prog Med. 1994 Nov;85(11):521-5.
The objective of the study was to evaluate the significance of the determination of antithyroid antibodies in hyperthyroid patients. Two-hundred-fifteen untreated Graves' hyperthyroid patients (active toxic diffuse goiter-TDG), 54 Plummer's hyperthyroid patients (focal hyperthyroidism) and 46 subjects with other forms of hyperthyroidism were studied. Serum levels of T4, T3, TSH, TSH receptor antibody (TRAb), microsomal antibody (TMAb), and thyroglobulin antibody (TGAb) were evaluated before starting treatment, at regular intervals during therapy, and during the follow-up period after therapy was withdrawn. The antibodies were positive in all patients with active and non-active TGD but positive in only two patients (3.7%) with focal hyperthyroidism. During the treatment interval, TRAb, TMAb and TGAb serum levels fell with a nadir in the 7th month of therapy. In particular, TRAb fell to normal levels in all patients who had basal levels less than 500 U/l (97.7% of the cases) while TMAb and TGAb remained positive. Relapses, following the completion of therapy, occurred in 20.4% after one year and in 33% after two years. Relapses were always linked to a new increase in TRAb. In conclusion, TRAb can be useful in the determination of early disease and in diagnosing remission. It did not appear useful as a prognostic indicator for relapse in individual patients.
本研究的目的是评估测定甲状腺功能亢进患者抗甲状腺抗体的意义。对215例未经治疗的格雷夫斯甲亢患者(活动性毒性弥漫性甲状腺肿-TDG)、54例普拉默甲亢患者(局灶性甲状腺功能亢进)和46例其他形式甲亢患者进行了研究。在开始治疗前、治疗期间定期以及停药后的随访期间,评估血清T4、T3、TSH、促甲状腺激素受体抗体(TRAb)、微粒体抗体(TMAb)和甲状腺球蛋白抗体(TGAb)水平。所有活动性和非活动性TGD患者的抗体均呈阳性,但仅2例(3.7%)局灶性甲状腺功能亢进患者的抗体呈阳性。在治疗期间,TRAb、TMAb和TGAb血清水平下降,在治疗第7个月时降至最低点。特别是,所有基础水平低于500 U/l的患者(97.7%的病例)的TRAb降至正常水平,而TMAb和TGAb仍为阳性。治疗结束后,1年后复发率为20.4%,2年后复发率为33%。复发总是与TRAb的再次升高有关。总之,TRAb可用于早期疾病的诊断和缓解的诊断。它似乎对个体患者复发的预后指标无用。