Objective; To evaluate the relationships between different levels of thyroid peroxidase antibody (TPOA) and thyroglobulin antibody (TGA) and the clinical manifestation in newly diagnosed Graves disease (GD) patients. Methods; Two hundred and ten newly diagnosed GD patients were divided into two groups (TPOA and TGA group). The two groups were divided again into three subgroups by quartiles of baseline TPOA and TGA level, respectively. Thus, TPOA group included TPOA-1 subgroup (TPOA <41. 0 kU/L), TPOA-2 subgroup (41. 0 kU/Ls≤TPOA <504. 5 kU/L) and TPOA-3 subgroup (TPOA≥s504. 5 kU/L), while TGA group was constituted by TGA-1 subgroup (TGA <58. 0 kU/L), TGA-2 subgroup (58. 0 kU/L≤TGA <573. 8 kU/L) and TGA-3 subgroup (TGA≥573. 8 kU/L). The clinical manifestations such as thyrotoxicosis, goiter, ophthalmopathy and the thyroid function among these groups were compared. Results; No significant difference between FT3 and FT4 were found in the groups with different levels of the two antibodies. In TPOA group, more patients in lower levels of TPOA subgroups showed one or two types of manifestations mentioned above (35. 7 % and 51.8%, respec-tively). However, more patients showed all of the manifestations in the subgroup with the highest level of TPOA, the rate of which was significantly higher than that of the lower level of TPOA subgroup (43. 4 % vs 12. 5 % , P < 0. 05). In TGA group, there was no significant difference in the proportion of the three types of symptoms among the three TGA subgroups. Correlation analysis showed that TPOA level was significantly related to thyroid volume (Spearman related coefficient =0. 284, P <0. 001), and TGA level was significantly related to the extent of oph-thalmopathy (Spearman related coefficient =0. 158, P =0. 022). Conclusion; The reason why different symptoms revealed in GD patients may be partly related to different degree and different characteristic of thyroid autoimmune. Higher level of TPOA may be more closely related to thyroid volume and higher level of TGA to ophthalmopathy.%目的:探讨甲状腺自身抗体过氧化物酶抗体(TPOA)和甲状腺结合球蛋白抗体(TGA)水平与新诊断的弥漫性甲状腺肿(GD)患者临床特征的关系.方法:将新诊断的210例GD患者分别按TPOA和TGA两种抗体的四分位数水平进行分层,TPOA组包括TPOA-1亚组(56例),TPOA＜41.0 kU/L；TPOA-2亚组(101例),41.0 kU/L≤TPOA＜504.5 kU/L；TPOA-3亚组(53例):TPOA≥504.5 kU/L.②TGA组包括TGA-1亚组(59例),TGA＜58.0 kU/L；TGA-2亚组(100例)58.0 kU/L≤TGA ＜573.8 kU/L；TGA-3亚组(51例),TGA≥573.8 kU/L.比较两种抗体不同水平的GD患者甲状腺毒症、甲状腺肿以及眼病等临床表现以及甲状腺激素(FT3、FT4)水平的差异.结果:两个抗体不同滴度GD患者的FT3、FT4比较差异无统计学意义；按TPOA滴度分层显示,在TPOA较低水平组(TPOA-1亚组),较多患者表现为甲状腺毒症、甲状腺肿大及眼病的1种或2种(分别占35.7％及51.8％),同时存在上述3种症状的比例为12.5％；在TPOA较高水平组(TPOA-3亚组),同时存在上述3种症状的比例显著高于TPOA-1亚组(P＜0.05)；相关分析显示,TPOA与甲状腺肿大的程度显著相关(Spearman相关系数为0.284,P＜0.001).按TGA滴度分层显示,在TGA较低水平组(TGA-1亚组)及较高水平组(TGA-3亚组),仅表现为眼病、甲状腺肿大或甲状腺毒症的其中之一或同时存在3种症状的比例无显著性差异(TGA-1亚组比例分别为33.9％、37.0％、39.2％,TGA-3亚组比例分别为28.8％、17.0％、17.7％；P＞0.05)；相关分析显示,TGA与眼病的程度显著相关(Spearman相关系数为0.158,P=0.022).结论:GD患者临床表现呈异质性的原因可能与甲状腺自身免疫的程度及特点不一样有关；高滴度TPOA与甲状腺肿大的关系更密切,高滴度TGA与眼病的关系更密切.
展开▼
