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血清TRAb动态监测在Graves病131I治疗中的应用
http://www.100md.com 2011年6月1日 李三喜
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     【摘要】目的:探讨血清TRAb动态监测在Graves病131I治疗中的应用价值。方法:350例Graves病患者和135名健康对照者分别于131I治疗前及治疗后3,6,9和12个月采用放射受体分析法(RRA)测定其TRAb水平。将治疗前TRAb水平与对照组、治疗后3个月与治疗前、治疗后6,9,12个月与对照组比较。结果:患者组血清TRAb水平治疗前〖(84.57±41.42)U/L〗明显高于健康对照组〖(7.86±13.18)U/L, P<0.01〗;治疗后3个月〖(62.21±28.51)U/L〗明显低于治疗前(P<0.01);治疗后6 〖(43.14±28.82)U/L〗,9 〖(16.88±12.32)U/L〗和12 〖(14.42±12.36)U/L〗个月逐渐下降,但仍明显高于对照组(P<0.01)。 结论:血清TRAb动态监测有助于Graves病的诊断和131I治疗后的随访监测和疗效评价。

    【关键词】Graves病;促甲状腺激素受体抗体;动态监测;131I治疗

    【中图分类号】R743.34 【文献标识码】A 【文章编号】1008-6455(2011)12-0099-01

    Application of Dynamic Monitoring of Serum TRAb after sup>131I Radiotherapy in Patients of Graves Disease

    Li Sanxi

    【Abstract】Objective:To explore the application value of dynamic monitoring of serum thyrotrophin receptor antibody (TRAb) after 131I radiotherapy in patients of Graves disease. Methods:A total of 350 patients with Graves disease and 135 normal controls were included in the study. Serum concentration of TRAb was measured by radioreptor assy (RRA) before and at 3,6,9 and 12 months after 131I radiotherapy. It were compared to TRAb concentration between before the treatment and control group, 3 months and before the treatment as well as 6,9,12 months and control group. Results:TRAb level 〖(84.57±41.42)U/L〗 before treatment in Graves disease group was obviously high than that of control group 〖(7.86±13.18)U/L, P<0.01〗. TRAb level 〖(62.21±28.51)U/L〗 after treatment was obviously low than that of before treatment(P<0.01). Although it dropped to (43.14±28.82)U/L, (16.88±12.32)U/L and (14.42±12.36)U/L at 6,9 and 12 months respectively after treatment, above TRAb levels were high than that of control group(P<0.01). Conclusion:Dynamic monitoring of serum TRAb is of clinical significance in the diagnosis of Graves disease and in the monitoring and efficacy evaluation of 131I radiotherapy.

    【Key words】Graves disease;Thyrotrophin Receptor Antibody (TRAb);Dynamic monitoring;131I radiotherapy

    弥漫性甲状腺肿伴甲状腺功能亢进(Graves病)是一种常见的自身免疫性疾病,有文献报道促甲状腺激素受体抗体(TRAb)是引起Graves病的重要原因,测定血清中的TRAb含量对该病的诊断、治疗、预后判断等方面有重要作用〖1〗。本文采用血清动态监测,测定了行131I治疗的Graves病患者在治疗前及治疗后3,6,9和12个月的TRAb水平,并与正常对照组比较。现报告如下。

    1 资料与方法

    1.1 临床资料:收集2009年6月至2010年6月在本科行131I治疗的350例Graves病患者为患者组,男95例,女255例,平均年龄(35.2±10.8)岁。正常对照组135例(男29例,女106例),平均年龄(34.6±11.4)岁,均无甲状腺疾病及其他内分泌疾病史,FT3、FT4、TSH水平均正常。

    1.2 方法

    1.2.1 检测方法:受检者均在上午空腹采取外周静脉血3ml,分离血清后置-20℃待测。TRAb的检测采用放射受体分析法(RRA);TSH采用免疫放射分析法(IRMA);FT3、FT4、TGAb和TMAb采用放射免疫分析法(RIA)

    1.2.2 治疗及随访:350例Graves病患者均使用131I治疗。治疗前检测患者血清FT3、FT4、TSH、TGAb(甲状腺蛋白抗体)、TMAb(甲状腺微粒体抗体)及TRAb。131I治疗用量=计划量×甲状腺重量÷甲状腺最高摄碘率 ......

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