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目的 探讨不同阶段Graves病患者血中TRAb含量变化。方法 采集 92例Graves病患者、2 0例其他甲状腺疾病患者和 30例正常人血液中 3种自身抗体的测定结果 ,按临床表现、甲状腺激素测定结果及治疗情况分为初发组、治疗缓解组、治疗未缓解或复发组、其他甲状腺病组。结果 初发组患者促甲状腺激素受体抗体 (TRAb)、甲状腺球蛋白抗体 (TGA)、甲状腺微粒体抗体 (MCA)的阳性率分别为 88% ,5 9%和 71% ;缓解组的TRAb显著低于初发组 (P <0 0 1) ,未缓解组与初发组差异无显著性 (P >0 0 5 ) ,缓解Ⅰ组与缓解Ⅱ组之间差异无显著性 (P >0 0 5 ) ,其中 5例停药 6个月至 3a的患者TRAb均阴性 ,未缓解Ⅱ组的 14例GD患者中有 6例为复发 ,其中有 5例阳性。TGA ,MCA除缓解Ⅱ组显著低于初发组 (P <0 0 5 )外 ,其他各组之间差异无显著性 (P >0 0 5 )。结论 TRAb在临床诊断Graves病及帮助医生决定是否停用抗甲亢药物 ,在预测抗甲亢药物治疗后的复发或缓解方面具有重要的临床价值
Objective To investigate the changes of TRAb levels in patients with Graves’ disease at different stages. Methods The blood samples of 92 patients with Graves disease, 20 patients with other thyroid diseases and 30 normal controls were collected. According to the clinical manifestations, the results of thyroid hormone test and the treatment were divided into the initial group, the treatment-remission group , Treatment did not alleviate or relapse group, other thyroid disease group. Results The positive rates of TRAb, TGA and MCA in the primary group were 88%, 59% and 71% respectively. The TRAb in the remission group was significantly higher than that in the remission group (P <0.01), but there was no significant difference between the untreated group and the primary group (P> 0.05). There was no significant difference between the two groups (P> 0 0) 5), of whom 5 had TRAb negative in 6 months to 3 years of withdrawal, and 6 of 14 GD patients in group 2 had no recurrence, of which 5 were positive. TGA and MCA had no significant difference among the other groups (P> 0.05) except that in group Ⅱ, which was significantly lower than that in initial group (P <0 05). Conclusion TRAb has important clinical value in predicting Graves’ disease and helping doctors to decide whether to stop anti-hyperthyroidism or not, and predicting relapse or remission after anti-hyperthyroidism treatment