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目的探讨~(131)I 治疗 Graves 甲状腺功能亢进症(简称甲亢)中动态监测血清促甲状腺激素受体抗体(TRAb)水平变化的临床价值。方法 130例 Graves 甲亢患者和50名健康对照者分别于~(131)I 治疗前及治疗后3,6,12和24个月采用放射受体分析法(RRA)测定其血清 TRAb 水平。数据用 x~-±s表示,组间差异用方差分析与 t 检验。结果 130例 Graves 甲亢患者在~(131)I 治疗前血清 TRAb水平[(92.93±68.99)U/L]高于健康对照组(P<0.01)。在~(131)I 治疗后3个月血清 TRAb 水平[(139.04±77.19)U/L]明显高于治疗前(P<0.01),治疗后6个月患者血清 TRAb 水平[(65.87±54.86)U/L]开始降低,但与对照组比较差异仍有统计学意义(P<0.01),在~(131)I 治疗12个月后血清TRAb 水平[(14.16±12.35)U/L]明显降低(P<0.01),到24个月患者血清 TRAb 水平[(12.99±5.52)U/L]与对照组比较差异无统计学意义(P>0.05)。结论在~(131)I 治疗前检测血清 TRAb 水平可指导~(131)I 的用量;在~(131)I 治疗后检测 Graves 甲亢患者的 TRAb 水平有助于随访监测及疗效评价,还可了解治疗后的免疫反应状态。
Objective To investigate the clinical value of serum thyrotropin receptor antibody (TRAb) level in ~ (131) I treatment of Graves’ hyperthyroidism (Hyperthyroidism). Methods 130 cases of Graves hyperthyroidism and 50 healthy controls were measured by radioimmunoassay (RRA) before treatment and at 3, 6, 12 and 24 months after treatment. Data with x ~ - s that differences between groups using analysis of variance and t test. Results The level of serum TRAb was significantly higher in patients with Graves’ hyperthyroidism before 131I treatment ([92.93 ± 68.99] U / L] than that in healthy controls (P <0.01). The levels of serum TRAb at three months after treatment with 131I (139.04 ± 77.19) U / L were significantly higher than those before treatment (P <0.01). The levels of serum TRAb at 6 months after treatment were 65.87 ± 54.86 (14.16 ± 12.35) U / L] decreased significantly after 12 months treatment with 131I treatment (P <0.01), but the difference was still significant compared with the control group (P <0.01) (P <0.01). The level of serum TRAb in 24 months patients [(12.99 ± 5.52) U / L] was not significantly different from the control group (P> 0.05). Conclusion The detection of serum TRAb level before ~ (131) I treatment can guide the usage of 131I. The detection of TRAb level in patients with Graves’ hyperthyroidism after ~ (131) I treatment is helpful for follow-up monitoring and curative effect evaluation. Post-treatment immune response.