摘要
目的 研究临床甲状腺功能减退症(甲减)患者血清甲状腺刺激阻断性抗体(TSBAb)与甲减病因、甲状腺功能、碘营养状态及病情预后的关系。方法 检测三个不同碘摄入量地区39例临床甲减患者的血清TSBAb、甲状腺刺激性抗体(TSAb)、甲状腺过氧化物酶抗体(TPOAb)和甲状腺球蛋白抗体(TgAb),两年后随访。TSBAb和TSAb采用重组人促甲状腺素受体(rhTSHR) 中国仓鼠卵巢细胞生物法测定。结果 自身免疫甲减组TSBAb活性为(48. 9±21. 1)%, 高于非自身免疫甲减组且显著高于对照组(P<0. 01); 自身免疫甲减组TSBAb阳性率40. 0%, 显著高于非自身免疫甲减组(0% )和对照组(均P<0. 05)。甲减患者TSBAb活性随地区碘摄入量的升高而增强(9. 3±18. 8)%、(41. 7±23. 1)%和(53. 8±13. 4)% (P<0. 01)。尿碘浓度>600μg/L组的TSBAb活性显著高于<300μg/L组[ (55. 4±19. 7)% vs(34. 9±24. 3)%,P<0. 05 ]。TPOAb>500U/ml者甲状腺功能恢复不明显, TPOAb<500U/ml者血清TSH和FT4显著恢复(均P<0. 05),同时TSBAb活性由初访(56. 0±16. 1)%降至随访(46. 0±4. 6)%。结论 TSBAb是自身免疫甲减的特异性标志物。临床甲减患者TSBAb活性与碘摄入量有关。在预测临床甲减转归中TPOAb具有重要意义。当TPOAb未达强阳性时。
Objective To investigate the relationship of serum thyroid stimulation blocking antibody (TSBAb) with etiology, thyroid function, iodine intake and prognosis in the patients with overt hypothyroidism. Methods Thirty-nine hypothyroid patients from 3 rural communities with different iodine intakes were studied in respect of TSBAb, thyroid stimulating antibody (TSAb), thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) in sera, and were followed 2 years later. TSBAb and TSAb were determined by recombinant human thyrotropin receptor (rhTSHR)-Chinese hamster ovary cell bioassay. Results The activity of TSBAb in autoimmune hypothyroidism was (48.9±21.1)%, higher than those from non-autoimmune hypothyroidism and normal control (P<0.01). The incidence of positive TSBAb in autoimmune hypothyroidism was 40%, higher than those from non-autoimmune hypothyroidism (0%) and control group (both P<0.05). With the increasing iodine intake in 3 communities, the activity of TSBAb increased correspondingly, which were (9.3±18.8)%, (41.7±23.1)% and (53.8±13.4)% (P<0.01), respectively. TSBAb activities were obviously higher in patients with urinary iodine concentration >600μg /L than in those with <300μg /L \[(55.4±19.7)% vs (34.9±24.3)%, P<0.05\]. In following-up, serum TSH and FT_ 4 improved simultaneously (both P<0.05) in patients with TPOAb lower than 500 U/ml, and their TSBAb decreased from (56.0±16.1)% to (46.0±4.6)%. However, there was no evident change in those with TPOAb over 500 U/ml. Conclusion TSBAb is a specific marker of autoimmune hypothyroidism. TSBAb activity is related with iodine intake in patients with overt hypothyroidism. Regarding to the prognosis of hypothyroidism, TPOAb is the most crucial autoantibody. Those with lower TPOAb recover preferably with decreased TSBAb.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2005年第2期114-117,共4页
Chinese Journal of Endocrinology and Metabolism
基金
国家自然科学基金资助项目 ( 30240013
30370680 )
美国中华医学基金会资助项目(98 688ITTD)
