促甲状腺激素受体抗体检测的临床意义.pdfVIP

·360 · 中华内分泌代谢杂志2011年4 月第27卷第4期摇 Chin J Endocrinol Metab,April2011,Vol. 27,No. 4 誗综述 誗 促甲状腺激素受体抗体检测的临床意义 杨昱摇 郑昂摇 刘超摇 蔡可英 摇 摇 揖提要铱摇 50年前人们发现了促甲状腺激素受体抗体(TRAb),随着对促甲状腺激素受体(TSHR)结构 和功能认识的不断更新,加之TSHR信号转导和与TRAb相互作用的逐步阐明,人们对TRAb及其临床应 用的认识得到了进一步提高。 TRAb 的检测在Graves病(GD)及Graves 眼病的诊断中有重要作用,并有效 预测GD经抗甲状腺药物或放射性碘治疗后复发。 其亦可应用于近期服碘的孕妇和乳母,因为甲状腺扫描 对她们来说是禁忌的。 另外,TRAb有助于胎儿、新生儿甲状腺功能亢进及其他类型的甲状腺毒症的诊断 和鉴别诊断。 目前,已有文献报道TRAb 阳性的GD患者发生甲状腺肿瘤及不良预后之间的可能联系,但 尚需更多的前瞻性研究来证实。 揖关键词铱摇 促甲状腺激素; 促甲状腺激素受体抗体; 格雷夫斯病; 方法学 * Clinical implicationsofthyrotropinreceptorantibodymeasurement摇 摇 YANGYu ,ZHENGAng,LIUChao, * CAIKe鄄ying. Endocrine and Diabetes Center,Jiangsu Province Hospital on Integration of Chinese and Western Medicine,Nanjing210028,China Correspondingauthor:LIUChao,Email:liuchao@ 揖Summary铱摇 Ithasbeen50yearssincethediscoveryofthyrotropinreceptorautoantibody(TRAb). Advances inthe knowledge of thyrotropin receptor(TSHR)structure and function,combined with the elucidation of TSHR signalingand TSHR鄄autoantibody interaction have greatly facilitated our understanding of TRAb and their clinical applications. Measurementof TRAb activity plays an important role in the diagnosis of Graves忆disease(GD)and Graves忆opthalmopathy. IthasalsobeenwellrecognizedthatTRAbisaneffectivepredictorofGDrelapseorremission afterantithyroiddrugandradioactiveiodinetreatment. TRAbtestisofparticularhelpinpregnantwomenandlactating motherswithrecentiodineload,where radioactive iodine or technetiumtestsare contraindicated. In addition,it is usefulinthediagnosisand differential diagnosisof fetal and neonatal hyperthyroidism aswell as some rareformsof thyrotoxicosisin clinical practice. Accumulating evidence also indicates the possible correlation between thyroid cancer occurring in GD patients with positiv