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目的探讨碘131(131I)治疗后Graves眼病(GO)预后与血清促甲状腺激素受体抗体(TRAb)水平变化之间的关系。方法选择2011年5月-12月初发Graves病患者238例,分为GO组124例和非GO组114例,分别检测131I治疗前及131I治疗后2、3、6个月甲状腺功能和TRAb,GO患者131I治疗前和治疗后6个月进行临床活动度评分(CAS)。结果 131I治疗前各组TRAb水平差异无统计学意义(P>0.05),TRAb水平与GO CAS评分之间无相关;131I治疗后6个月所有患者TRAb水平显著增加;非GO组有5例新发GO,新发GO组与其他患者的TRAb水平分别为(58.7±77.9)、(61.9±81.1)U/L,差异无统计学意义(P>0.05);GO组又分为GO无变化29例,GO加重17例,GO缓解78例,三组患者TRAb水平分别为(53.5±77.6)、(66.2±89.9)、(66.8±42.2)U/L,差异无统计学意义(P>0.05)。结论 131I治疗后患者TRAb水平显著增加,但TRAb水平的变化和GO预后无关,TRAb与GO的关系还需要进一步研究。
Objective To investigate the relationship between the prognosis of Graves ophthalmopathy (GO) and serum thyrotropin receptor antibody (TRAb) levels after 131I treatment. Methods 238 patients with Graves’ disease were selected from May 2011 to December 2011. The patients were divided into GO group (124 cases) and non-GO group (114 cases). Thyroid function and TRAb were detected before 131I treatment and at 2,3,6 months after 131I treatment respectively. Clinical activity score (CAS) was assessed in GO patients before 131I and 6 months after treatment. Results The levels of TRAb in each group before 131I treatment had no significant difference (P> 0.05). There was no correlation between TRAb level and GO CAS score. The levels of TRAb in all patients at 6 months after 131I treatment significantly increased. The levels of TRAb in GO group, new onset GO group and other patients were (58.7 ± 77.9) and (61.9 ± 81.1) U / L, respectively, with no significant difference (P> 0.05) In the three groups, TRAb levels were (53.5 ± 77.6), (66.2 ± 89.9) and (66.8 ± 42.2) U / L, respectively, with no significant difference (P> 0.05) . Conclusion The level of TRAb in patients after 131I treatment is significantly increased, but the changes of TRAb level are not related to the prognosis of GO. The relationship between TRAb and GO needs to be further studied.