Significance Of The Change On Thyrotropin Receptor Antibody(TRAb) Titer In Graves’ Disease Patients Treated With Antithyroid Drug

Objective To observe the change of serum thyrotropin receptor antibody titer before and after treatment with antithyroid drugs in newly diagnosed Graves’ disease,and to analyse the correlation between TRAb titer and TPOAb,ATGAb titer in newly diagnosed Graves’ disease,and analyse the correlation between TRAb titer and drug dosage,duration of treatment and thyroid function in the course of antithyroid drug treatment.Methods A total of 32 newly diagnosed Graves’ disease patients were collected in the Department of Endocrinology,The Second Hospital of Lanzhou University from December 2016 to August 2018.The treatment process was divided into three phases:initial treatment period,drug dose reduction period and drug dose maintenance peroid.Three items of thyroid function(TSH,FT3,FT4)and TRAb,TPOAb,ATGAb were tested in the initial treatment period.In the process of treatment,three items of thyroid function were detected,and the dosage was adjusted according to the treatment response.In the drug dose reduction period and maintenance peroid,tested the thyroid function and TRAb titer.To observe the change of TRAb titer and thyroid function during drug treatment,and analyze the correlation between TRAb titer and thyroid function,drug dosage,treatment time,TPOAb and ATGAb in the course of drug treatment.Results1 84% of GD patients were TRAb positive in newly diagnosed Graves’ Disease,and the median(IQR)of serum TRAb titer was 7.73(2.74,15.28)IU/L.75% of GD patients were positive in drug dose reduction period,and the median(IQR)of serum TRAb titer was 5.08(1.49,9.21)IU/L,66% of GD patients were TRAb positive indose maintenance period and the median(IQR)of serum TRAb titer was 2.27(1.26,5.75)IU/L.The serum TRAb titer showed a downward trend during the whole course of treatment.There was significant difference in serum TRAb titer between the initial treatment period and the dose reduction period,the dose maintenance period(P<0.001,P<0.001).There was significant difference in serum TRAb titer between the reduction period and the maintenance period(P < 0.05).2 78% of newly diagnosed GD patients were TPOAb positive and 53% were ATGAb positive.The change of serum thyroid function during drug treatment was statistically significant.3 There was no correlation between serum TRAb titer and levels of TSH,FT3,FT4,TPOAb and ATGAb titer during drug treatment(all of these result was P >0.05).4 There was low positive correlation between serum TRAb titer and drug dose in patients with Graves’ disease during initial treatment peroid(r = 0.36 < 0.5,P < 0.05),but no correlation with treatment time(P > 0.05);there was significant positive correlation between serum TRAb titer and drug dose,treatment time during drug dose reduction period(r = 0.68 > 0.5,P < 0.05;r = 0.64 > 0.5,P < 0.05).Conclusion1 The positive rate of TRAb in newly diagnosed patients with Graves’ disease was significantly increased,and the titer of TRAb decreased with the extension of medication time.2 There is no clear correlation between serum thyroid function and TRAb titer in patients with Graves’ disease receiving antithyroid drug treatment.Therefore,in the course of Graves’ disease treatment,we should not only refer to the thyroid function,but also consider the change of TRAb titer.3 There is no clear correlation between serum TRAb titer and TPOAb,ATGAb titer in patients with Graves’ disease.