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格雷夫斯病患者的甲状腺激素自身抗体:抗甲状腺药物治疗的效果

Thyroid hormone autoantibodies in patients with Graves' disease: effect of anti-thyroid drug treatment.

作者信息

Ogawa T, Sakata S, Nakamura S, Takuno H, Matsui I, Sarui H, Yasuda K

机构信息

Third Department of Internal Medicine, Gifu University School of Medicine, Japan.

出版信息

Clin Chim Acta. 1994 Aug;228(2):113-22. doi: 10.1016/0009-8981(94)90282-8.

Abstract

We examined the effects of anti-thyroid drug treatment on serum autoantibodies against thyroid hormones (thyroid hormone autoantibodies, THAA), thyroglobulin (Tg) and thyroid peroxidase (TPO) in patients with Graves' disease by measuring each autoantibody level before and after treatment. Six patients among 40 untreated patients with Graves' disease had anti-thyroxine (T4) antibodies. One patient had both anti-T4 and anti-triiodothyronine (T3) antibodies. Thus the prevalence of THAA in untreated Graves' disease was 7 out of 40 (17.5%). Changes in T4-Ab levels after treatment varied. In five cases (cases 3-7) levels decreased 4-7 months after treatment. However, in the other two cases levels fluctuated 1, 3, 6 and 12 months after treatment. None of the previously THAA-negative patients became positive after treatment. Anti-Tg antibody (Tg-Ab) was positive in 34 out of 40 (85%) untreated cases and its level decreased in both THAA positive and negative patients after treatment. Anti-thyroid peroxidase antibody (TPO-Ab) was positive in 32 of the 40 (80%) untreated Graves' patients and its level significantly decreased after treatment. Our findings suggest that treatment with anti-thyroid drugs does not produce THAA in Graves' disease.

摘要

我们通过测量抗甲状腺药物治疗前后的自身抗体水平,研究了抗甲状腺药物治疗对格雷夫斯病患者血清中抗甲状腺激素自身抗体(甲状腺激素自身抗体,THAA)、甲状腺球蛋白(Tg)和甲状腺过氧化物酶(TPO)的影响。40例未经治疗的格雷夫斯病患者中有6例存在抗甲状腺素(T4)抗体。1例患者同时存在抗T4和抗三碘甲状腺原氨酸(T3)抗体。因此,未经治疗的格雷夫斯病患者中THAA的患病率为40例中的7例(17.5%)。治疗后T4抗体水平变化各异。在5例患者(病例3 - 7)中,治疗后4 - 7个月抗体水平下降。然而,在另外2例患者中,治疗后1、3、6和12个月抗体水平出现波动。之前THAA阴性的患者治疗后均未转为阳性。40例未经治疗的病例中有34例(85%)抗甲状腺球蛋白抗体(Tg - Ab)呈阳性,治疗后THAA阳性和阴性患者的该抗体水平均下降。40例未经治疗的格雷夫斯病患者中有32例(80%)抗甲状腺过氧化物酶抗体(TPO - Ab)呈阳性,治疗后该抗体水平显著下降。我们的研究结果表明,抗甲状腺药物治疗不会在格雷夫斯病患者中产生THAA。

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