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; 促甲状腺激素受体抗体; 放射性碘治疗; 预后

DOI：

10.7507/1002-0179.20130590

Video：

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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。

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.	中华医学会内分泌学分会《中国甲状腺疾病诊治指南》编写组. 中国甲状腺疾病诊治指南—甲状腺功能亢进症[J]. 中华内科杂志, 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, 童南伟. Graves眼病的诊断和治疗[J]. 内科理论与实践, 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.	Bałdys-Waligórska A, Gołkowski 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.	宋补昌, 李宝兰, 孙斌. 血清TRAb检测对Graves’病突眼的应用价值[J]. 放射免疫学杂志, 2005, 18(6): 478-479.
15.	唐武儒, 韦南仕. TRAb 水平测定在甲亢并突眼治疗中的意义探讨[J]. 右江民族医学院学报, 2006, 28(1): 56-56.
16.	王亚萍, 肖锦华, 朱华燕, 等. 全自动电化学发光免疫分析法检测血清TRAb的方法学评价[J]. 放射免疫学杂志, 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.	何建华, 曾钦文. TSH受体抗体及临床意义[J]. 国外医学·放射医学核医学分册, 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. 　中华医学会内分泌学分会《中国甲状腺疾病诊治指南》编写组. 中国甲状腺疾病诊治指南—甲状腺功能亢进症[J]. 中华内科杂志, 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, 童南伟. Graves眼病的诊断和治疗[J]. 内科理论与实践, 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. 　Bałdys-Waligórska A, Gołkowski 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. 　宋补昌, 李宝兰, 孙斌. 血清TRAb检测对Graves’病突眼的应用价值[J]. 放射免疫学杂志, 2005, 18(6): 478-479.
15. 　唐武儒, 韦南仕. TRAb 水平测定在甲亢并突眼治疗中的意义探讨[J]. 右江民族医学院学报, 2006, 28(1): 56-56.
16. 　王亚萍, 肖锦华, 朱华燕, 等. 全自动电化学发光免疫分析法检测血清TRAb的方法学评价[J]. 放射免疫学杂志, 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. 　何建华, 曾钦文. TSH受体抗体及临床意义[J]. 国外医学·放射医学核医学分册, 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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