天津医药

天津医药 ›› 2016, Vol. 44 ›› Issue (6): 769-771.doi: 10.11958/20150409

• 临床研究 • 上一篇    下一篇

血清 TPOAb 水平对 Graves 病患者抗甲状腺药物治疗的影响

卢泽芬 1， 于佳 2， 任丽萍 3， 郝杰 1， 何庆 4   

  1. 1沧州市人民医院 （邮编 061000）； 2天津市海河医院； 3天津大学医院； 4天津医科大学总医院
  • 收稿日期:2015-12-21 修回日期:2016-04-12 出版日期:2016-06-15 发布日期:2016-07-04
  • 基金资助:
    国家自然科学基金资助项目 （81170740）

Effects of serum level of TPOAb on Graves disease in patients using anti-thyroid drug treatment

LU Zefen1, YU Jia2, REN Liping3, HAO Jie1, HE Qing4   

  1. 1 Cangzhou People’ s Hospital, Cangzhou 061000, China; 2 Tianjin Haihe River Hospital; 3 Tianjin University Hospital; 4 General Hospital of Tianjin Medical University
  • Received:2015-12-21 Revised:2016-04-12 Published:2016-06-15 Online:2016-07-04

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摘要： 摘要： 目的 分析血清甲状腺过氧化物酶抗体 （TPOAb） 水平对初发 Graves 病 （GD） 患者抗甲状腺药物 （ATD） 治疗的影响。方法 选择应用 ATD 治疗满 12 个月的初发 GD 患者 121 例， 将其分为 TPOAb 阴性组 49 例（TPOAb≤ 35 IU/mL）和阳性组 72 例（TPOAb＞35 IU/mL）， 根据 TPOAb 滴度水平将阳性组分为阳性低组（35 IU/mL＜TPOAb≤ 200 IU/mL， 19 例）、 中组（200 IU/mL＜TPOAb≤500 IU/mL， 20 例）、 高组（500 IU/mL＜TPOAb≤1 000 IU/mL， 13 例）、 极高组（TPOAb＞1 000 IU/mL， 20 例）， 比较治疗 12 个月各组 ATD 总用量以及治疗 3、 6、 12 个月时阴性组和阳性组促甲状腺激素（TSH）恢复正常的比例。结果 TPOAb 阳性组 ATD 的总用药量为（1 743.82±265.38） mg， 低于阴性组（1 889.18±125.51） mg； TPOAb 阳性低、 中、 高、 极高组总用药量分别为（1 759.71±230.29） mg、（1 793.75±299.02） mg、（1 731.54±236.44） mg 和（1 710.00±290.73） mg。TPOAb 阳性组在治疗 3 个月时 TSH 恢复正常的比例明显高于阴性组 （P＜0.05）。结论 GD 患者血清 TPOAb 阳性会导致 ATD 治疗的疗程缩短、 总用药量减少。

关键词: 格雷夫斯病, 过氧化物酶, 自身抗体, 甲状腺, 抗甲状腺药, 用药剂量

Abstract: Abstract: Objective To analyse effects of the serum levels of thyroid peroxidase antibodies (TPOAb) on antithyroid drugs (ATD) treatment in patients with incipient Graves disease (GD). Methods A total of 121 patients with incipient GD, who were used anti thyroid drugs for 12 months, were included in this study. Patients were dvided into two groups: TPOAb negative group (TPOAb≤35 IU/mL, n=49) and TPOAb positive group (TPOAb > 35 IU/mL, n=72). According to the degree of TPOAb drops the TPOAb positive group was sub-divided into low level positive group (35 IU/mL < TPOAb≤200 IU/mL, n=19), medium level positive group (200 IU/mL＜TPOAb≤ 500 IU/mL, n=20), high level positive group (500 IU/mL＜ TPOAb≤1 000 IU/mL, n=13), and very high level positive group (TPOAb > 1 000 IU/mL, n=20). The ATD total dosage for 12 months and thyroid-stimulating hormone (TSH), which returned to normal rate after treatment of 3, 6 and 12 months, were compared between groups. Results ATD total dose was lower in TPOAb positive group (1 743.82±265.38) mg than that of negative group (1 889.18 ±125.51) mg. The ATD total dosages were (1 759.71±230.29) mg, (1 793.75±299.02) mg, (1 731.54± 236.44) mg and (1 710.00±290.73) mg for low level TPOAb positive group, medium level TPOAb positive group, high level TPOAb positive group, and very high level TPOAb positive group respectively. The recovering ratio of TSH was significantly higher in TPOAb positive group than that of TPOAb negative group after 3-month treatment (P < 0.05). Conclusion TPOAb positive serum can lead to shorten the course of ATD treatment and reduce the total amount of ATD treatment in GD patients.

Key words: Graves disease, peroxidase, autoantibodies, thyroid gland, antithyroid agents, drug dosage