Graves病治疗前后细胞因子水平的变化

Changes of serum cytokine levels before and after treatment of Graves' disease

目的 探讨1 31 I和抗甲状腺药物 (ATD)治疗对Graves病 (GD)患者血清细胞因子水平及免疫功能的不同影响。方法 用放射免疫分析法检测 87例接受ATD治疗、14 6例接受1 31 I治疗的GD患者治疗前及治疗后 30 ,6 0 ,180和 36 0d外周血清白细胞介素 2 (IL 2 )、白细胞介素 6 (IL 6 )、肿瘤坏死因子 (TNF α)浓度变化 ,并与血清FT3、FT4 、促甲状腺激素 (TSH)进行相关性分析。结果 GD患者血清IL 6、TNF α水平显著高于对照组 (P <0 0 1) ,IL 2显著低于对照组 (P <0 0 1) ;血清IL 6与TNF α水平呈正相关 (P <0 0 5 ) ,与IL 2、FT3、FT4 、TSH水平无相关性 ;1 31 I治疗与ATD治疗对GD患者血清细胞因子的影响程度不一致。结论 1 31 I和ATD治疗可影响血清细胞因子的表达。多种细胞因子水平变化与病程和治疗结果密切相关。

Objective To study the effects of 131 I and antithyroid drug (ATD) on the serum cytokine levels of patients with Graves' disease (GD). Methods Using the method of radioimmunoassay,the levels of interleukin-2(IL-2),interleukin-6 (IL-6) and tumor necrosis factor(TNF-α) in serum of 233 patients were measured before and after 131 I or ATD therapy,and the results were compared with that of the control group. Results The levels of IL-6,TNF-α of GD patients were significantly higher than that of the control group(P<0.01),the serum level of IL-2 of GD patients was significantly lower than that in the control subjects (P<0.01). The serum level of IL-6 positively correlated with TNF-α (P<0.05),but not with other clinical parameters(IL-2,FT_3,FT_4,TSH). The effects of 131 I and ATD therapy on serum cytokines of GD patients were different. Conclusion Cytokines play certain roles in the progressing of GD,both 131 I and ATD can inhibit immunological responses at different levels in GD,and the concentrations of cytokines are related to the clinical course and therapeutic outcome of GD.