促甲状腺激素受体抗体检测的临床意义.pdf

中华内分泌代谢杂志年月第卷第期
·360·20114274摇ChinJEndocrinolMetab,April2011,Vol.27,No.4
综述
誗誗
促甲状腺激素受体抗体检测的临床意义

杨昱郑昂刘超蔡可英
摇摇摇

揖提要铱年前人们发现了促甲状腺激素受体抗体随着对促甲状腺激素受体结构
摇摇摇50(TRAb),(TSHR)
和功能认识的不断更新加之信号转导和与相互作用的逐步阐明人们对及其临床应
,TSHRTRAb,TRAb
用的认识得到了进一步提高的检测在病及眼病的诊断中有重要作用并有效
。TRAbGraves(GD)Graves,
预测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
GD。,
对她们来说是禁忌的另外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
。,TRAb、
和鉴别诊断目前已有文献报道阳性的患者发生甲状腺肿瘤及不良预后之间的可能联系但
。,TRAbGD,
尚需更多的前瞻性研究来证实
。
揖关键词铱促甲状腺激素促甲状腺激素受体抗体格雷夫斯病方法学
摇;;;

Clinicalimplicationsofthyrotropinreceptorantibodymeasurement摇摇YANGYu*ZHENGAngLIUChao
,,,
CAIKe鄄ying.*EndocrineandDiabetesCenterJiangsuProvinceHospitalonIntegrationofChineseandWestern
,
MedicineNanjingChina
,210028,
[e-mail]
:,:
Summary
揖铱摇Ithasbeen50yearssincethediscoveryofthyrotropinreceptorautoantibody(TRAb).Advances
intheknowledgeofthyrotropinreceptor(TSHR)structureandfunction,combinedwiththeelucidationofTSHR
signalingandTSHR鄄autoantibodyinteractionhavegreatlyfacilitatedourunderstandingofTRAbandtheirclinical
applications.MeasurementofTRAbactivityplaysanimportantroleinthediagnosisofGraves忆disease(GD)and
Graves忆opthalmopathy.IthasalsobeenwellrecognizedthatTRAbisaneffectivepredictorofGDrelapseorremission
afterantithyroiddrugandradioactiveiodinetreatment.TRAbtestisofparticularhelpinpregnantwomenandlactating
motherswithrecentiodineload,whereradioactiveiodineortechnetiumtestsarecontraindicated.Inaddition,itis
usefulinthediagnosisanddifferentialdiagnosisoffetalandneonatalhyperthyroidismaswellassomerareformsof
thyrotoxicosisinclinicalpractice.Accumulatingevidencealsoindicatesthepossiblecorrelationbetweenthyroid
canceroccurringinGDpatientswithpositiveTRAbandadverseoutcomes.However,furtherinnovationand
standardizationofTRAbtestsarerequiredtohelppavethewayforclinicalapplications.
Keywords
揖铱摇Thyrotropin;Thyrotropinreceptorantibody;Graves忆disease;Methodology
ChinJEndocrinolMetab
(,2011,27:360鄄364)

自身免疫性甲状腺疾病包括个类别受体抗体也称为
摇摇(autoimmunethyroiddiseases,TRAb3:(1)TSH(TRAb):TSH