摘要
目的探讨血清甲状腺球蛋白抗体(TGAb)、甲状腺微粒体抗体(TMAb)、甲状腺过氧化物酶抗体(TPOAb)水平与Graves病患者治疗后甲状腺功能减退(简称甲减)发生率的关系。方法选取2014年5月至2015年6月在该院接收治疗的Graves病患者90例作为研究对象,对所有的患者进行分组,按照患者的TGAb、TPOAb水平分为阳性组(观察组)和阴性组(对照组),分别对患者在接受治疗前后的TGAb、TMAb、TPOAb水平,以及甲减发生率进行比较和分析。结果观察组患者治疗前与治疗后的TGAb、TPOAb水平比较,差异无统计学意义(P>0.05),对照组患者在治疗后TGAb、TPOAb水平与治疗前相比明显升高,差异有统计学意义(P<0.05),两组患者的TMAb水平治疗前后比较,差异无统计学意义(P>0.05);对照组患者的早发甲减发生率为22.50%,观察组患者为48.00%,组间比较,差异有统计学意义(P<0.05)。以发生甲减患者治疗后的促甲状腺激素(TSH)水平作为应变量,分别以TGAb、TPOAb、TMAb为自变量进行直线相关分析,结果显示发生甲减患者TSH水平与TGAb、TPOAb呈显著正相关(r分别为0.401、0.456,P<0.05)。结论于治疗前对Graves病患者进行甲状腺自身抗体检测,对患者的治疗具有积极的指导意义。对于阳性患者,131I的用量应当根据患者的具体情况适当地减少,以避免发生甲减;对于阴性患者,在接受131I治疗后TPOAb、TGAb水平的升高是否与甲减的发生率降低或者是甲亢复发有关,尚待进一步的探究。
Objective To explore the correlation between serum TGAb,TMAb and TPOAb levels with the incidence of hypothyroidism after treatment in the patients with Graves disease.Methods Ninety cases of Graves disease treated in our hospital from May 2014 to June 2015 were selected as the research subjects and divided into the positive group（observation group）and negative group（control group）according to the TGAb and TPOAb levels.The TGAb,TMAb and TPOAb levels before and after treatment and hypothyroidism occurrence rate were compared between the two groups and analyzed.Results The TGAb and TPOAb level in the observation group had no statistical difference between before and after treatment（P〉0.05）;the TGAb and TPOAb levels after treatment in the control group were significantly increased compared with before treatment,the difference was statistically significant（P〈0.05）;the TMAb level had no statistically significant difference between before and after treatment（P〉0.05）;the occurrence rate of early onset hypothyroidism was 22.50%in the control group and which of hypothyroidism in the observation group was 48.00%,the difference was statistically significant（P〈0.05）.With the TSH level as the dependent variable and TGAb,TPOAb and TMAb as the independent variables after treatment in the patients with hypothyroidism,the linear correlation analysis was performed,the results showed that the TSH level in the patients with hypothyroidism was significantly correlated with TGAb and TPOAb（r=0.401,0.456,P〈0.05）.Conclusion The detection of thyroid autoantibodies before treatment in the patients with Graves disease has a positive guiding significance for the treatment of patients.For positive patients,the dosage of 131 I should appropriate to reduce according to the specific circumstances of the patients to avoid the hypothyroidism occurrence;for negative patients,whether the increase of TPOAb and TGAb levels being related with the low incidence rate of hypothyroidism or hyperthyroidism recurrence need to be further researched.
出处
《检验医学与临床》
CAS
2017年第6期816-818,共3页
Laboratory Medicine and Clinic
