摘要
探讨Graves病131I治疗后的转归与细胞因子IL-2、IL-10、TNF-α之间的关系。158例Graves病首次接受131I治疗的患者在治疗前和治疗后5个月分别抽取静脉血,检测IL-2、IL-10、TNF-α和T3、T4、FT3、FT4和s-TSH。根据治疗后5个月T3、T4、FT3、FT4和s-TSH含量分为甲亢未控制组、甲亢控制组和早发性甲减组。结果显示,IL-2、IL-10各组患者治疗前、后均明显高于对照组(P<0.01),TNF-α早发性甲减组治疗前、后均高于对照组(P<0.05)。IL-2治疗前后组间比较,甲亢未控制组最高,甲亢控制组次之,早发性甲减组最低,三组治疗后均高于治疗前(P<0.05);IL-10治疗后甲亢未控制组明显高于其余两组(P<0.01);THF-α治疗前后组间比较,早发性甲减组高于其余两组(P<0.01)。IL-2/IL-10比值治疗前后组间比较,甲亢未控制组最高、甲亢控制组其次,早发性甲减组最低。作者认为,Graves病患者机体免疫状态处于一个较高的水平,以Th1细胞因子优势表达为主。IL-2/IL 10比值越高,越难控制,IL-2/IL-10比值越低越易产生甲减。Graves病患者治疗前、后TNF-α含量高的患者容易发生早发性甲减。
To investigate the relationship between prognosis of Graves＇ disease （GD） treated with 131^I and IL-2, IL-10 and TNF-α, the levels of IL-2, IL-10, TNF-α, T3, T4 , FT3, FT4 and s-TSH in serum of 158 patients with GD were measured before first 131^I treatment and after five months. The patients were divided into the transient hypothyroidism group, the hyperthyroidism group and the cure group according to the serum level of T3, T4 , FT3, FT4 and s-TSH after fives months of treatment. The results showed that the IL-2 and IL-10 levels in GD patient were remarkably higher （P〈0.01） compared with the controls. The TNF-α level in the hyperthyroidism group was higher than that in control group before and after 131^I treatment. The serum IL-2 level in each group after 131^I treatment was higher than that of before treatment （P〈0. 05）. The IL-2 levels in patients before and after treatment are in the order of the hyperthyroidism group 〉the cure group 〉the transient hypothyroidism group. The levels of IL-10 in the hyperthyroidism group after treatment were higher than those in the cure and the transient hypothyroidism group （P〈0.01）. The levels of TNF-α in patients in the transient hypothyroidism group were higher than those in the cure and hyperthyroidism group （P〈0.01）. The ratio of IL-2 to IL-10 is in the order of the hyperthyroidism group 〉 the transient hypothyroidism group 〉 the cure group. The results indicate that Thl plays a predominant role in the pathogenesis of GD, in which the cytokines production is shifted toward the Thl type. The patients with lower ratio of IL-2 to IL-10 and higher level of TNF-α occur hypothyroidism easily.
出处
《标记免疫分析与临床》
CAS
2007年第3期150-153,共4页
Labeled Immunoassays and Clinical Medicine
