CAJ | 학술논문

目的探讨甲状腺刺激性抗体(TSAb)水平和甲状腺体积等相关因素对Graves病患者抗甲状腺药物治疗停药后复发的预测价值.方法 71例Graves病患者经抗甲状腺药物正规治疗(2.8±1.4)年后停药,随访(22±6.0)个月.对停药后复发与未复发组的年龄、性别及停药时的TSAb活性、甲状腺体积和甲状腺功能指标等进行分析比较.应用表达重组人促甲状腺激素受体的人胚肾(HEK-hTSHR)细胞测定TSAb活性.结果 71例患者随访期间有11例(15.5%)复发,治疗停药时TSAb阳性患者复发率(42.9%,6/14)显著高于阴性患者(8.8%,5/57,X2=9.97,P<0.01).停药时甲状腺正常体积、Ⅰ度肿大、Ⅱ度肿大复发比率分别为6.25%、12.2%、35.7%.复发组患者停药时TSAb活性、阳性率以及甲状腺体积均显著高于未复发组(P<0.05或P<0.01).结论 Graves病患者抗甲状腺药物治疗终止时TSAb活性和甲状腺大小是Graves病停药后复发的有效预测因子.
목적 탐토갑상선자격성항체(TSAb)수평화갑상선체적등상관인소대Graves병환자항갑상선약물치료정약후복발적예측개치.방법 71례Graves병환자경항갑상선약물정규치료(2.8±1.4)년후정약,수방(22±6.0)개월.대정약후복발여미복발조적년령、성별급정약시적TSAb활성、갑상선체적화갑상선공능지표등진행분석비교.응용표체중조인촉갑상선격소수체적인배신(HEK-hTSHR)세포측정TSAb활성.결과 71례환자수방기간유11례(15.5%)복발,치료정약시TSAb양성환자복발솔(42.9%,6/14)현저고우음성환자(8.8%,5/57,X2=9.97,P<0.01).정약시갑상선정상체적、Ⅰ도종대、Ⅱ도종대복발비솔분별위6.25%、12.2%、35.7%.복발조환자정약시TSAb활성、양성솔이급갑상선체적균현저고우미복발조(P<0.05혹P<0.01).결론 Graves병환자항갑상선약물치료종지시TSAb활성화갑상선대소시Graves병정약후복발적유효예측인자.
Objective To explore the value of thyroid-stimulating antibody(TSAb) and degree of goiter in predicting the outcome of Graves'disease after antithyroid drug treatment. Methods Seventy-one patients with Graves'disease were given antithyroid drugs for (2. 8±1. 4)years and then followed up for(22±6.0)months.Finally,age,gender,thyroid function,TSAb and goiter size at the time of drug withdrawal were compared between the relapsed and relieved groups. TSAb was measured in all patients by using HEK-hTSHR cells. Results Eleven of 71 patients relapsed during the follow-up after drug withdrawal. The relapse rate (42. 9% ,6/14)in patients with positive TSAb was significantly higher than that (8.8%, 5/57) in patient with negative TSAb (X2 = 9.97, P<0.01). The relapse rates in patients with normal size thyroid, Ⅰ degree goiter,Ⅱ degree goiter were 6.25%, 12.2%,35.7% respectively. TSAb activity, positive rate and goiter size of the relapsed patients at the time of drug withdrawal were significantly higher than those of relieved patients (P<0.05 or P<0. 01). Conclusion TSAb activity and goiter size at the time of drug withdrawal are two effective prognostic markers of relapse in Graves' disease treated with antithyroid drugs.