中国实用内科杂志2018，Vol.38Issue(1)：52-55,4.DOI:10.19538/j.nk2018010114
高IgG4水平Graves病临床特征研究
Clinical features of Graves' disease with elevated IgG4 level
摘要
Abstract
Objective To investigate the clinical features of Graves' disease (GD) with elevated so as serum IgG4 levels to guide the clinical practice.Methods Patients were classified into two groups according to the IgG4 level which was detected by nephelometric immunoassay:positive group (IgG4 ＞ 1.35g/L) and negative group.The clinical characteristics of these two groups were compared,including age,gender,thyroid function,ultrasound,history of autoimmune diseases,and so on.Results Ten out of 114 patients with GD had elevated serum IgG4 level,20％ of whom were male.The age,BMI,FT3,FT4,TgAb and TPOAb levels,the incidence of exophthalmos in positive group and negative group were not statistically different.In positive group,the age of onset was younger (32.21±15.01y vs.33.87±13.64y,P=0.482),but there was no statistical significance.Compared to negative group,patients with increased IgG4 concentration had lower TSH level (0.29±0.83 mU/L vs.3.09±14.90 mU/L,P=0.013),higher TRAb level (17.37±13.61 U/L vs.9.13±12.04 U/L,P=0.017) and higher dosage of ATD (17.13±8.62mg vs.9.08±7.93mg,P=0.005).These differences were statistical.Correlation analysis showed that IgG4 level was positively correlated with TRAb,r=0.339,P=0.016.Conclution GD patients with positive IgG4 are more severe than those with negative IgG4,and the dosage is higher,and they are more likely to relapse.Clinically,patients with severe hyperthyroidism or frequent recurrence should be considered to receive detection of serum IgG4 concentration.If necessary,glucocorticoid administration should be considered.For patients with high TRAb level,evaluation of serum IgG4 is necessary.Those with high IgG4 level and stable TSH level should be treated with glucocorticoid.关键词
血清IgG4/Graves病/临床特征Key words
serum IgG4 level/Graves' disease/clinical feature分类
医药卫生引用本文复制引用
江帆,陈国芳,徐书杭,刘超..高IgG4水平Graves病临床特征研究[J].中国实用内科杂志,2018,38(1):52-55,4.基金项目
国家自然科学基金(81471010,81600600) （81471010,81600600）
