^(131)I对Graves病可溶性细胞凋亡蛋白Fas的影响

Dynamic study on the influence of ^(131)I treatment on the circulating sFas levels in patients with Graves′disease

目的探讨131I治疗对Graves病(GD)患者循环血可溶性细胞凋亡相关蛋白Fas(sFas)的影响。方法采用酶联免疫吸附试验(ELISA)和放射免疫分析法(RIA)分别检测52例GD患者131I治疗前及治疗后30、90和180d血清sFas和甲状腺激素水平,并进行相关性分析,30例年龄与性别相匹配的健康者作为正常对照。结果GD患者血清sFas水平(2·48±1·05)ng/ml显著高于对照组(1·34±0·41)ng/ml(P<0·01);131I治疗180d后,甲状腺功能恢复正常,症状缓解,sFas水平逐渐下降,但仍高于对照组(P<0·05);血清sFas与促甲状腺激素受体抗体(TRAb)呈正相关,与FT3、FT4和TSH没有相关性。结论GD患者体内存在sFas异常表达,131I治疗能有效抑制GD患者自身免疫,其治疗前后循环血sFas的动态变化可能与GD发病与转归的病理生理过程有关。

Objective To study the influence of 131^ I treatment on the circulating sFas levels of patients with Graves＇disease （GD） before and after treatment with 131^I. Methods Using the method of enzyme-linked immunosorbent assay（ELISA） and radioimmunoassay, the levels of sFas in serum and thyroid hormone of GD 52 patients were measured before and after 131^ I therapy while 30 healthy subjects with age and sex matched served as controls, and the results were compared with that of the control group. Results The sFas levels in serum of GD patients were significantly higher than that of the control group（ P 〈 0.01 ）. The serum sFas level tended to decrease after the medication of ^131 I at 180 d, but still higher than that of the normal controls（ P 〈 0.05）. The concentration of serum sFas was positively correlated with the titers of anti-hyrotropin （TSH） receptor antibody （ r = 0. 595, P 〈 0.01 ）, but not with the other clinical parameters （ FT3 , FT4 and TSH ）. Conclusions Abnormal concentration of sFas in serum can be observed in patients with GD. 131^I therapy would suppress the auto-immune status in GD patients, and the circulating sFas may play a role in the pathogenesis of GD.