目的 探討碘131（131I）治療后Graves眼?。℅O）預(yù)后與血清促甲狀腺激素受體抗體（TRAb）水平變化之間的關(guān)系。 方法 選擇2011年5月－12月初發(fā)Graves病患者238例，分為GO組124 例和非GO組114 例，分別檢測(cè)131I治療前及131I治療后2、3、6個(gè)月甲狀腺功能和TRAb，GO患者131I治療前和治療后6 個(gè)月進(jìn)行臨床活動(dòng)度評(píng)分（CAS）。 結(jié)果 131I治療前各組TRAb水平差異無統(tǒng)計(jì)學(xué)意義（P＞0.05），TRAb水平與GO CAS評(píng)分之間無相關(guān)；131I治療后6個(gè)月所有患者TRAb水平顯著增加；非GO組有5例新發(fā)GO，新發(fā)GO組與其他患者的TRAb水平分別為（58.7 ± 77.9）、（61.9 ± 81.1）U/L，差異無統(tǒng)計(jì)學(xué)意義（P＞0.05）；GO組又分為GO無變化29例，GO加重17例，GO緩解78例，三組患者TRAb水平分別為（53.5 ± 77.6）、（66.2 ± 89.9）、（66.8 ± 42.2）U/L，差異無統(tǒng)計(jì)學(xué)意義（P＞0.05）。 結(jié)論 131I治療后患者TRAb水平顯著增加，但TRAb水平的變化和GO預(yù)后無關(guān)，TRAb與GO的關(guān)系還需要進(jìn)一步研究。
【摘要】 目的 以99mTc-DTPA腎動(dòng)態(tài)顯像法腎小球?yàn)V過率（glomerular filtration rate，GFR）測(cè)定為標(biāo)準(zhǔn)，將血清胱抑素C（cystatin C， CysC）檢測(cè)與其比較，探討CysC測(cè)定在2型糖尿病腎病（type 2 diabetic nephropathy，T2DN）診斷中的意義?！》椒ā?010年6月—2011年1月76例2型糖尿?。╰ype 2 diabetes mellitus，T2DM）患者按24 h尿微量白蛋白（microalbuminuria，m-Alb）分為兩組:正常蛋白尿組（31例）和微量蛋白尿組（45例），同時(shí)測(cè)定GFR、CysC、血清肌酐（serum creatinine， Scr）和糖化血紅蛋白（hemoglobin A1c， HbA1c），并設(shè)正常自愿者38名作為對(duì)照組，進(jìn)行統(tǒng)計(jì)學(xué)分析?！〗Y(jié)果 對(duì)照組、T2DM正常蛋白尿組及T2DM微量蛋白尿組CysC水平分別為（1.1±0.6）、（1.6±0.7）、（1.0±0.3） mg/L，各組差異均有統(tǒng)計(jì)學(xué)意義（Plt;0.05）；HbA1c水平分別為（5.4±0.6）%、（7.1±2.7）%、（7.9±3.1）%、兩組T2DM患者與對(duì)照組比較，差異均有統(tǒng)計(jì)學(xué)意義（Plt;0.05）；GFR水平分別為（80.9±23.0）、（74.2±26.1）、（79.3±19.7） mL/（min?1.73 m2），各組差異無統(tǒng)計(jì)學(xué)意義（Pgt;0.05）；Scr水平分別為（87.7±23.8）、（93.7±38.4）、（81.5±11.4） μmol/L，組間差異無統(tǒng)計(jì)學(xué)意義（Pgt;0.05）。CysC、Scr和GFR之間呈負(fù)相關(guān)（r=-0.694，-0.692；Plt;0.001）；CysC和Scr之間呈正相關(guān)（r=0.903，Plt;0.001）?！〗Y(jié)論 CysC可作為早期T2DN的檢測(cè)指標(biāo)，具有較高的敏感性，但對(duì)于輕度到中度GFR降低的診斷準(zhǔn)確性并不優(yōu)于Scr。【Abstract】 Objective To demonstrate the clinical value of serum cystatin-C (CysC) in the assessment of renal function in type-2 diabetic nephropathy (T2DN) by comparing it with the glomerular filtration rate (GFR) measured by 99mTc-DTPA method. Methods From June 2010 to January 2011, 76 patients with type 2 diabetes mellitus (T2DM) were classified into two groups according to their 24 h microalbuminuria (m-Alb) level: the normal albuminuric group (n=31) and the microalbuminuric group (n=45). GFR, Serum creatinine (Scr), CysC, and hemoglobin A1c (HbA1c) were measured. Thirty-eight healthy subjects were recruited as the control group, and statistical analysis was carried out. Results The CysC levels in the control group, the normal albuminuric group and the microalbuminuria group were respectively (1.1±0.6), (1.6±0.7) and (1.0±0.3) mg/L, with a significant difference among the three groups (Plt;0.05). HbA1c level in the three groups were respectively (7.1±2.7)%, (7.9±3.1)% and (5.4±0.6)%, with a significant difference between the two diabetic groups and the control group (Plt;0.05). Scr levels in the three groups were respectively (87.7±23.8), (93.7±38.4), (81.5±11.4) μmol/L; GFR levels in the three groups were respectively (80.9±23.0), (74.2±26.1), (79.3±19.7) mL/(min?1.73 m2); among the three groups the differences of both Scr and GFR were not significant. Both CysC and Scr were negatively correlated with GFR (r=-0.694,-0.692;Plt;0.001), and CysC was positively correlated with Scr (r=0.903, Plt;0.001). Conclusion Increased CysC may be an early indicator of incipient diabetic nephropathy, but the diagnostic accuracy of CysC is not superior to that of Scr in distinguishing between mildly and moderately reduced GFR.