Change of Serum TRAb Level in Patients with Graves’ Ophthalmopathy before and after Treated with 131I_West China Medical Journal

Authors：

DONG Yanwu ,  SHI Yuhong , LUO Wenyi , YAN Bing.

Department of Nuclear Medicine, 416 Hospital, Chengdu, Sichuan 610051, P. R. China;

Corresponding?author：

SHI Yuhong, Email: dywzbdwk@163.com

Keywords：

Graves 病; Graves眼病; 促甲狀腺激素受體抗體; 放射性碘治療; 預后

DOI：

10.7507/1002-0179.20130590

Video：

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目的　探討碘131（131I）治療后Graves眼病（GO）預后與血清促甲狀腺激素受體抗體（TRAb）水平變化之間的關系。方法　選擇2011年5月－12月初發Graves病患者238例，分為GO組124 例和非GO組114 例，分別檢測131I治療前及131I治療后2、3、6個月甲狀腺功能和TRAb，GO患者131I治療前和治療后6 個月進行臨床活動度評分（CAS）。結果　131I治療前各組TRAb水平差異無統計學意義（P＞0.05），TRAb水平與GO CAS評分之間無相關；131I治療后6個月所有患者TRAb水平顯著增加；非GO組有5例新發GO，新發GO組與其他患者的TRAb水平分別為（58.7 ± 77.9）、（61.9 ± 81.1）U/L，差異無統計學意義（P＞0.05）；GO組又分為GO無變化29例，GO加重17例，GO緩解78例，三組患者TRAb水平分別為（53.5 ± 77.6）、（66.2 ± 89.9）、（66.8 ± 42.2）U/L，差異無統計學意義（P＞0.05）。結論　131I治療后患者TRAb水平顯著增加，但TRAb水平的變化和GO預后無關，TRAb與GO的關系還需要進一步研究。

Citation： DONG Yanwu,SHI Yuhong,LUO Wenyi,YAN Bing.. Change of Serum TRAb Level in Patients with Graves’ Ophthalmopathy before and after Treated with 131I. West China Medical Journal, 2013, 28(12): 1868-1871. doi: 10.7507/1002-0179.20130590 Copy

1.	Tallstedt L, Lundall G, Torring O, et al. Occurrence of ophthalmopathy aftertreatment for Graves’ hyperthyroidism[J]. N Engl J Med, 1992, 326(26): 1733-1738.
2.	Bartalena L, Marcocci C, Bogazzi F, et al. Relation between therapy for hyperthyroidism and the course of Graves’ ophthalmopathy[J]. N Engl J Med, 1998, 338(2): 73-78.
3.	Kung AW, Yau CC, Cheng A. The incidence of ophthalmopathy after radioiodine therapy for Graves’ disease: prognostic factors and the role of methimazole[J]. J Clin Endocrinol Metab, 1994, 79(2): 542-546.
4.	Perros P, Kendall-Taylor P, Neoh C, et al. A prospective study of the effects of radioiodine therapy for hyperthyroidism in patients with minimally active Graves’ ophthalmopathy[J]. J Clin Endocrinol Metab, 2005, 90(9): 5321-5323.
5.	中華醫學會內分泌學分會《中國甲狀腺疾病診治指南》編寫組. 中國甲狀腺疾病診治指南—甲狀腺功能亢進癥[J]. 中華內科雜志, 2007, 46(10)：876-882.
6.	Bartley GB, Corman CA. Diagnostic criteria for Graves’ ophthalmopathy[J]. Am J Ophthahnol, 1995, 119(6): 792-795.
7.	曹明明, 童南偉. Graves眼病的診斷和治療[J]. 內科理論與實踐, 2010, 5(2): 177-179.
8.	James CS, Matthew JS, Christine CN, et al. Radioiodine therapy and Graves’ Ophthalmopathy[J]. J Nucl Med, 2008, 49(6): 923-930.
9.	Vannucchi G, Campi I, Covelli D, et al. Graves’ orbitopathy activation after radioactive Iodine therapy with and without steroid prophylaxis[J]. J Clin Endocrinol Metab, 2009, 94(9): 3381-3386.
10.	Ba?dys-Waligórska A, Go?kowski F, Kusnierz-Cabala B, et al. Graves’ ophthalmopathy in patients treated with radioiodine 131-I[J]. Endokrynol Pol, 2011, 62(3): 214-219.
11.	Crisp MS, Lane C, Halliwell M, et al. Thyrotropin receptor transcripts in humadipose tissue[J]. J Clin Endocrinol Metab, 1997, 82(6): 2003-2005.
12.	Feliciello A, Porcellini A, Ciullo I, et al. Expression of thyrotropin-receptor mRNA in healthy and Graves’ disease retro-orbital tissue[J]. Lancet, 1993, 342(8867): 337-338.
13.	Boschi A, Daumerie Ch, Spiritus M, et al. Quantification of cells expressing the thyrotropin receptor in extraocular muscles in thyroid associated orbitopathy[J]. Br J Ophthalmol, 2005, 89(6): 724-729.
14.	宋補昌, 李寶蘭, 孫斌. 血清TRAb檢測對Graves’病突眼的應用價值[J]. 放射免疫學雜志, 2005, 18(6): 478-479.
15.	唐武儒, 韋南仕. TRAb 水平測定在甲亢并突眼治療中的意義探討[J]. 右江民族醫學院學報, 2006, 28(1): 56-56.
16.	王亞萍, 肖錦華, 朱華燕, 等. 全自動電化學發光免疫分析法檢測血清TRAb的方法學評價[J]. 放射免疫學雜志, 2011, 24(6): 661-664.
17.	Subekti I, Boedisantoso A, Moeloek ND, et al. Association of TSH receptor antibody, thyroid stimulating antibody, and thyroid blocking antibody with clinical activity score and degree of severity of Graves ophthalmopathy[J]. Acta Med Indones, 2012, 44(2): 114-121.
18.	何建華, 曾欽文. TSH受體抗體及臨床意義[J]. 國外醫學·放射醫學核醫學分冊, 2001, 25(3): 111-114.

1. 　Tallstedt L, Lundall G, Torring O, et al. Occurrence of ophthalmopathy aftertreatment for Graves’ hyperthyroidism[J]. N Engl J Med, 1992, 326(26): 1733-1738.
2. 　Bartalena L, Marcocci C, Bogazzi F, et al. Relation between therapy for hyperthyroidism and the course of Graves’ ophthalmopathy[J]. N Engl J Med, 1998, 338(2): 73-78.
3. 　Kung AW, Yau CC, Cheng A. The incidence of ophthalmopathy after radioiodine therapy for Graves’ disease: prognostic factors and the role of methimazole[J]. J Clin Endocrinol Metab, 1994, 79(2): 542-546.
4. 　Perros P, Kendall-Taylor P, Neoh C, et al. A prospective study of the effects of radioiodine therapy for hyperthyroidism in patients with minimally active Graves’ ophthalmopathy[J]. J Clin Endocrinol Metab, 2005, 90(9): 5321-5323.
5. 　中華醫學會內分泌學分會《中國甲狀腺疾病診治指南》編寫組. 中國甲狀腺疾病診治指南—甲狀腺功能亢進癥[J]. 中華內科雜志, 2007, 46(10)：876-882.
6. 　Bartley GB, Corman CA. Diagnostic criteria for Graves’ ophthalmopathy[J]. Am J Ophthahnol, 1995, 119(6): 792-795.
7. 　曹明明, 童南偉. Graves眼病的診斷和治療[J]. 內科理論與實踐, 2010, 5(2): 177-179.
8. 　James CS, Matthew JS, Christine CN, et al. Radioiodine therapy and Graves’ Ophthalmopathy[J]. J Nucl Med, 2008, 49(6): 923-930.
9. 　Vannucchi G, Campi I, Covelli D, et al. Graves’ orbitopathy activation after radioactive Iodine therapy with and without steroid prophylaxis[J]. J Clin Endocrinol Metab, 2009, 94(9): 3381-3386.
10. 　Ba?dys-Waligórska A, Go?kowski F, Kusnierz-Cabala B, et al. Graves’ ophthalmopathy in patients treated with radioiodine 131-I[J]. Endokrynol Pol, 2011, 62(3): 214-219.
11. 　Crisp MS, Lane C, Halliwell M, et al. Thyrotropin receptor transcripts in humadipose tissue[J]. J Clin Endocrinol Metab, 1997, 82(6): 2003-2005.
12. 　Feliciello A, Porcellini A, Ciullo I, et al. Expression of thyrotropin-receptor mRNA in healthy and Graves’ disease retro-orbital tissue[J]. Lancet, 1993, 342(8867): 337-338.
13. 　Boschi A, Daumerie Ch, Spiritus M, et al. Quantification of cells expressing the thyrotropin receptor in extraocular muscles in thyroid associated orbitopathy[J]. Br J Ophthalmol, 2005, 89(6): 724-729.
14. 　宋補昌, 李寶蘭, 孫斌. 血清TRAb檢測對Graves’病突眼的應用價值[J]. 放射免疫學雜志, 2005, 18(6): 478-479.
15. 　唐武儒, 韋南仕. TRAb 水平測定在甲亢并突眼治療中的意義探討[J]. 右江民族醫學院學報, 2006, 28(1): 56-56.
16. 　王亞萍, 肖錦華, 朱華燕, 等. 全自動電化學發光免疫分析法檢測血清TRAb的方法學評價[J]. 放射免疫學雜志, 2011, 24(6): 661-664.
17. 　Subekti I, Boedisantoso A, Moeloek ND, et al. Association of TSH receptor antibody, thyroid stimulating antibody, and thyroid blocking antibody with clinical activity score and degree of severity of Graves ophthalmopathy[J]. Acta Med Indones, 2012, 44(2): 114-121.
18. 　何建華, 曾欽文. TSH受體抗體及臨床意義[J]. 國外醫學·放射醫學核醫學分冊, 2001, 25(3): 111-114.

West China Medical Journal

Change of Serum TRAb Level in Patients with Graves’ Ophthalmopathy before and after Treated with 131I

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