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目的探讨Graves病甲状腺功能亢进症(简称甲亢)131I治疗前后甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)水平的变化及与早发甲状腺功能减退症(简称早发甲减)发生的关系。方法对81例Graves病患者131I治疗前依据TGAb、TPOAb水平分为阳性组(A组,46例)和阴性组(B组,35例),分别检测治疗前与治疗后6个月FT3、FT4、促甲状腺激素(TSH)、TGAb、TPOAb水平。结果A组治疗前后TGAb、TPOAb抗体水平无明显变化(P>0.05),早发甲减发生率47.8%;B组治疗后较治疗前TGAb、TPOAb水平明显升高(P<0.01),早发甲减发生率22.9%,两组131I治疗后早发甲减发生率有统计学意义(P<0.05)。早发甲减患者TSH水平与TGAb、TPOAb呈显著正相关(r=0.405,0.378,P=0.026,0.035),与甲状腺大小有一定的相关性(r=0.366,P=0.051)。结论治疗前高水平的TGAb、TPOAb早发甲减发生率明显增高,尤其是甲状腺较小者。TGAb、TPOAb阴性者131I治疗后抗体水平升高,其机制有待进一步临床观察。
Objective To investigate the changes of thyroglobulin antibody (TGAb) and thyroid peroxidase antibody (TPOAb) in patients with Graves’ disease of hyperthyroidism before and after 131I treatment and the correlation with the early hypothyroidism (hypothyroidism) What happened? Methods Totally 81 cases of Graves’ disease were divided into positive group (group A, 46 cases) and negative group (group B, 35 cases) according to TGAb and TPOAb levels before 131I treatment. The levels of FT3, FT4 , Thyrotropin (TSH), TGAb, TPOAb levels. Results The levels of TGAb and TPOAb antibody in group A before and after treatment did not change significantly (P> 0.05), and the incidence of early hypothyroidism was 47.8%. The levels of TGAb and TPOAb in group B were significantly higher than those before treatment (P <0.01) The incidence of hypothyroidism was 22.9%. The incidence of early hypothyroidism after 131I treatment in both groups was statistically significant (P <0.05). TSH levels in patients with early hypothyroidism were positively correlated with TGAb and TPOAb (r = 0.405,0.378, P = 0.026,0.035), and had a certain correlation with thyroid size (r = 0.366, P = 0.051). Conclusion The high incidence of pre-treatment TGAb, TPOAb early hypothyroidism was significantly higher, especially in those with smaller thyroid glands. TGAb, TPOAb negative 131I antibody levels after treatment, the mechanism remains to be further clinical observation.