Nishikawa M, Yoshimura M, Toyoda N, Masaki H, Yonemoto T, Gondou A, Kato T, Kurokawa H, Furumura T, Inada M
Second Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
Acta Endocrinol (Copenh). 1993 Sep;129(3):213-9. doi: 10.1530/acta.0.1290213.
To evaluate the relationship between eye changes and autoantibody to the thyrotropin receptor in patients with Graves' disease, we evaluated the eye changes using magnetic resonance imaging and the results were correlated with thyroid-stimulating antibody, thyrotropin binding inhibitor immunoglobulin and thyroid growth activity. Subjects were 15 patients with Graves' disease who had Graves' ophthalmopathy, including exophthalmos and other signs and symptoms, and nine patients without ophthalmopathy; all were maintained in a euthyroid state by antithyroid drugs. The thyrotropin-binding inhibitor immunoglobulin was measured by a kit, and thyroid-stimulating antibody and thyroid growth activity were evaluated by cyclic adenosine 3',5'-monophosphate production and [3H]thymidine incorporation, respectively, by cultured functional rat thyroid lined cells. The sum of the swelling ratios (muscle thickness to the diameter of the optic nerve) of the four extraocular muscles correlated well with the degree of exophthalmos. The thyrotropin-binding inhibitor immunoglobulin was positive in nine out of 15 patients with ophthalmopathy; however, no correlation was observed between the activity and exophthalmos or muscle swelling. No significant correlation was observed between muscle changes and thyroid growth activity either. On the other hand, thyroid-stimulating antibody (642 +/- 91%) in Graves' patients with ophthalmopathy was significantly (p < 0.02) higher than that (315 +/- 84%) in patients without ophthalmopathy. Moreover, the level of stimulating activity in Graves' patients with ophthalmopathy showed a significant (p < 0.02) positive correlation with the sum of the swelling ratios of the individual eight eye muscles. These results suggest that thyroid-stimulating antibody has a close relation to Graves' ophthalmopathy.
为了评估格雷夫斯病患者眼部变化与促甲状腺素受体自身抗体之间的关系，我们使用磁共振成像评估眼部变化，并将结果与促甲状腺素刺激抗体、促甲状腺素结合抑制免疫球蛋白和甲状腺生长活性进行关联分析。研究对象为15例患有格雷夫斯眼病（包括眼球突出及其他体征和症状）的格雷夫斯病患者以及9例无眼病的患者；所有患者均通过抗甲状腺药物维持甲状腺功能正常状态。促甲状腺素结合抑制免疫球蛋白采用试剂盒进行检测，促甲状腺素刺激抗体和甲状腺生长活性分别通过培养的功能性大鼠甲状腺细胞中环磷酸腺苷的生成和[3H]胸腺嘧啶核苷掺入进行评估。四条眼外肌肿胀率（肌肉厚度与视神经直径之比）的总和与眼球突出程度密切相关。15例眼病患者中有9例促甲状腺素结合抑制免疫球蛋白呈阳性；然而，未观察到其活性与眼球突出或肌肉肿胀之间存在相关性。肌肉变化与甲状腺生长活性之间也未观察到显著相关性。另一方面，患有眼病的格雷夫斯病患者的促甲状腺素刺激抗体（642±91%）显著高于（p<0.02）无眼病患者（315±84%）。此外，患有眼病的格雷夫斯病患者的刺激活性水平与八只眼肌各自肿胀率的总和呈显著（p<0.02）正相关。这些结果表明促甲状腺素刺激抗体与格雷夫斯眼病密切相关。
