TRAb在Graves病~(131)I治疗中的临床价值

目的:探讨促甲状腺激素受体抗体(TRAb)在Graves病131I治疗中的临床价值。方法:回顾性分析我院经131I治疗的186例Graves病患者,与70例健康对照组分别于131I治疗前及治疗后3、6、12和18月采用电化学发光免疫分析法(ECLA)动态检测血清TRAb、FT3、FT4、TSH浓度变化,进行统计分析,并计算TRAb的阳性率。结果:70例健康对照组TRAb水平1.09±0.45 IU/L,186例Graves病131I治疗前血清TRAb水平9.95±7.18 IU/L,明显高于健康对照组,两组比较有显著的统计学意义(t=-10.306,P0.001)。131I治疗3月后TRAb水平14.81±10.37 IU/L,明显高于治疗前(t=-5.26,P0.001);131I治疗6月后TRAb水平12.33±8.73 IU/L开始下降,治疗12月后TRAb水平3.14±0.87 IU/L明显降低;治疗18月后TRAb水平1.19±0.45 IU/L与健康对照组比较差异无统计学意义(t=-1.588,P=0.113)。Graves病131I治疗前TRAb阳性率为93.5%,治疗后3、6、12、18个月TRAb阳性率分别为93.5%、79.6%、27.4%和8.6%。结论:Graves病131I治疗中检测TRAb水平具有指导治疗、判断疗效、预测复发等重要的临床价值。

Clincal Value of SerumTRAb in Graves' Disease Before and After 131I Therapy

Objective： To investigate the clincal value of serum TRAb in Graves＇ disease before and after ^131I therapy. Methods： A total of 186 patients of Graves＇ disease and 70 normal controls were included in the study. Serum concentration of TRAb were measured by ECLA before and at 3,6,12 and 18 months after ^131I radiotherapy. Results： The TRAb level of 70 normal controls was （1.09± 0.45） IU/L. Abnormally higher TRAb level（9.95± 7.18 IU/L） was noted in patients before ^131I treatment（t= -10.31,P 〈 0.001）. The TRAb level increased to （14.81± 10.37 IU/L） at 3 months after ^131I therapy （t=-.26, P〈0.001） ,before it dropped to （12.33± 8.73 IUFL） and （3.14± 0.87 IU/L） at 6 and 12 months respectively （t=-.89 and t=-2.85, P〈0.05）.At 18 months after ^131I radiotherapy,the level of TRAb （1.19±0.45 IU/L） was back to normal with no difference to that ofnomal controls（t=-1.59, P〉0.05）. Before ^131I treatment of Graves＇ disease TRAb positive rate was 93.5% and at 3,6, 12,18 months after treatment TRAb positive rates were 93.5%, 79.6%, 27.4% and 8.6%. Conclusion： It is of great significance to measure serum concentrations of TRAb after ^131I radiotherapy for Graves＇ disease, which is of important clinical value for therapy guidance, efficacy assessment and recurrence prediction.