Clinical Features and Thyroid Histology of T3-Predominant Graves' Disease.

T3为主型格雷夫斯病的临床特征和甲状腺组织学。

基本信息

批准号：
63570553
负责人：
TAKAMATSU Junta
金额：
$ 1.22万
依托单位：
Osaka Medical College
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1988
资助国家：
日本
起止时间：
1988 至 1990
项目状态：
已结题

项目摘要

When patients with T_3 -predominant Graves' disease were compared with usual Graves' disease patients,1. Serum autoantibodies to thyroid peroxidase and TSH receptor were higher, while autoantibodies to thyroglobulin were not different. Thyroid-stimulating antibodies determined by cultured porcine thyroid cells were greater.2. The goiter size was greater with more hyperplastic epithelium and more intracolloidal vacuoles.3. Thyroid ^<123>I uptake was higher at 3h than 24h, suggesting enhanced thyroidal iodine turnover.4. The degree of exophthalmos of Graves' disease was not different.5. The activity of thyroid peroxidase was greater, while thyroglobulin content in the thyroid was smaller. Iodine content in thyroglobulin was also smaller. Thyroid 5' -deiodinase was greater, which may be one of the causes of increased serum T_3 relative to T_4.6. An experiment of coupling reaction using individual microsomal fractions and pooled thyroglobulin showed relatively increased T_3 production than T_4, suggesting a unique characteristic of thyroid peroxidase in this disorder.7. Clinical follow-up study showed that remission of hyperthyroidism was hardly obtained by antithyroid drug therapy. After subtotal thyroidectomy, the frequency of relapse was greater. While, after radioiodine therapy, the frequency of late-onset hypothyroidism was lower, indicating that radioiodine therapy is beneficial in this type of Graves' disease.

当T_3为主的格雷夫斯病患者与普通格雷夫斯病患者进行比较时，1．血清甲状腺过氧化物酶和TSH受体自身抗体较高，而甲状腺球蛋白自身抗体无差异。培养猪甲状腺细胞测定的促甲状腺抗体较高。2．甲状腺肿大，增生上皮较多，胶内空泡较多。3．甲状腺^ 123 I摄取在3小时高于24小时，表明甲状腺碘周转增强。4． Graves病的突眼程度无差异。5．甲状腺过氧化物酶活性较高，而甲状腺中甲状腺球蛋白含量较低。甲状腺球蛋白中的碘含量也较少。甲状腺5'-脱碘酶较高，这可能是血清T_3相对于T_4.6升高的原因之一。使用单独的微粒体组分和合并的甲状腺球蛋白进行偶联反应的实验显示，T_3 的产生比 T_4 相对增加，表明甲状腺过氧化物酶在这种疾病中具有独特的特征。 7．临床随访研究表明，抗甲状腺药物治疗很难使甲亢得到缓解。甲状腺次全切除术后，复发频率更高。而放射性碘治疗后，迟发性甲状腺功能减退症的发生率较低，表明放射性碘治疗对此类格雷夫斯病有益。