Tireotropin (TSH) retseptoriga qarshi antikoralar (TRAb)
Kod:9009
| Kabi | TSH retseptoriga qarshi antikoralar |
|---|
Tahlil ma'lumotlari
Tadqiqot usuli
- Elektrokimyoluminessent immunoanaliz (ECLIA)
Kutilayotgan natija topshirish vaqti
1 kun
Maxsus tayyorlik
- Do not smoke for at least 30 minutes before the blood draw.
- Stop high-dose biotin (vitamin B7/B8, vitamin H, coenzyme R) for a minimum of 72 hours before specimen collection.
Qanday foydalanish
Tireotropin (TSH) retseptoriga qarshi antikoralar (TRAb) testi — qalqonsimon bezni stimullovchi immunoglobulinlar (TSI) yoki TSH bilan bog'lanishni to'suvchi immunoglobulinlar (TBII) nomi bilan ham ma'lum — Grevs kasalligini tasdiqlash va antikoralar vositachiligidagi tireotoksikozni gipertireozning boshqa etiologiyalaridan farqlash uchun qo'llanadi. Shuningdek, bloklovchi antikoralar vositachiligidagi gipotireoz gumon qilinganda qo'llanadi. Seriyali TRAb o'lchovlari kasallik faolligini baholash, prognozni — jumladan qaytalanish ehtimolini — belgilash va antitireoid dorilarga javobni kuzatish uchun ishlatiladi. Homiladorlikda radionuklid muolajalar cheklanadigan sharoitda TRAb tekshiruvi hozirgi yoki o'tmishda Grevs kasalligi bo'lgan bemorlarni baholashni qo'llab-quvvatlaydi va neonatal qalqonsimon bez disfunktsiyasi xavfini baholashga yordam beradi.
Cheklovlar
TSH retseptoriga qarshi antikoralar asosan IgG sinfiga mansub, TSH retseptoriga bog'lanadigan geterogen avtoantikoralar guruhidir. Ba'zilari stimullovchi bo'lib, diffuz zob va gipertireoz bilan birga qalqonsimon bez gormonlarining ortiqcha ishlab chiqarilishini qo'zg'atadi, boshqalari esa bloklovchi bo'lib, retseptor signalizatsiyasini susaytiradi va natijada gipotireozga olib keladi. Ushbu antikoralar Grevs kasalligida to'g'ridan-to'g'ri patogen mexanizm hisoblanadi va autoimmun tireoiditda ham uchrashi mumkin. Stimullovchi antikoralar (ko'pincha qalqonsimon bezni stimullovchi immunoglobulinlar deb yuritiladi) Grevs kasalligiga chalingan bemorlarning taxminan 85% dan 100% gachaida aniqlanadi, va ularning titrlari umumiy kasallik faolligi hamda qalqonsimon bez bilan bog'liq oftalmopatiyaning og'irligi bilan korelyatsiyalanadi. Konsentratsiyalar odatda samarali antitireoid terapiya bilan pasayadi, va vaqt bo'ylab ketma-ket o'lchash boshqaruv qarorlariga yordam beradi hamda davolashdan keyin qaytalanish ehtimolini baholashga xizmat qiladi. TRAb platsenta orqali o'tadi va neonatal tireotoksikozni keltirib chiqarishi mumkin; bloklovchi antikoralar esa o'tkinchi neonatal gipotireozga olib kelishi mumkin. Homiladorlikda TRAb baholash qalqonsimon bez sintigrafiyasiga nurlanmasiz muqobilni taqdim etadi. TRAb Grevs kasalligi uchun to'liq spetsifik emas va Xashimoto tireoiditiga ega ayrim shaxslarda ham aniqlanishi mumkin.
| O'lchov birligi | IU/L |
|---|---|
| Referens oraliq | — |
| Ko'rsatmalar | Features of thyrotoxicosis—such as palpitations or tachycardia, tremor, heat intolerance, weight loss despite increased appetite, and oligomenorrhea—especially when accompanied by thyroid eye disease or pretibial myxedema., Atypical or equivocal presentations of Graves disease, including mild or borderline biochemical thyrotoxicosis, a small or difficult-to-palpate goiter, or ophthalmopathy in an euthyroid state or limited to one eye., Symptoms consistent with hypothyroidism, including fatigue, excessive sleepiness, cognitive slowing, weight gain with decreased appetite, and cold intolerance., Pregnancy in a patient with a history of Graves disease managed with surgery or radioiodine, or with ongoing antithyroid medication., Pregnant patients with clinical signs or laboratory evidence of hypothyroidism. |
Natija og'ishlarining mumkin sabablari
Oshgan daraja
- biotin (high-dose supplementation)
Pasaygan daraja
- antithyroid drugs
Namunangiz talablari
| Namunangiz | Zardob |
|---|---|
| Container | Oltin/yo'lbars qopqoqli probirka (SST, gel ajratgich) |
References
Cho BY. Clinical applications of TSH receptor antibodies in thyroid diseases. J Korean Med Sci. 2002 Jun;17(3):293-301.
Michalek K, Morshed SA, Latif R, Davies TF. TSH receptor autoantibodies. Autoimmun Rev. 2009 Dec;9(2):113-6.
Fauci et al. Harrison's Principles of Internal Medicine/A. Fauci, D. Kasper, D. Longo, E. Braunwald, S. Hauser, J. L. Jameson, J. Loscalzo; 17 ed. – The McGraw-Hill Companies, 2008.
Chernecky C. C. Laboratory Tests and Diagnostic Procedures / C.C. Chernecky, B.J. Berger; 5th ed. – Saunder Elsevier, 2008.