Th1/Th2细胞因子结合甲状腺自身抗体检测在自身免疫性甲状腺疾病中的诊断价值

The Diagnostic Value of Th1/Th2 Cell Cytokine and Thyroid Autoantibody on Autoimmune Thyroid Diseases

研究Th1/Th2细胞因子和甲状腺自身抗体在自身免疫性甲状腺疾病(AITD)中的诊断价值。选择Graves病(GD)28例、甲亢甲炎(GDIII)15例、桥本甲亢(HTL)13例、桥本甲状腺炎(HT)21例、20名正常人,通过酶免法检测血清Th1型细胞因子γ干扰素(IFN-γ)和Th2型细胞因子白细胞介素-4(IL-4)的含量,与放免法测定的促甲状腺激素受体抗体(TRAb)、甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)进行相关分析。结果显示,IFN-γ水平HT>HTL>GDIII>GD,IL-4水平GD>GDIII>HTL>HT。GDIII和HTL组IFN-γ和IL-4水平均有统计学意义(P<0.05,P<0.01),GDIII和HTL组TGAb、TPOAb无统计学意义(P>0.05)。HT组IFN-γ与TGAb、TPOAb正相关(r分别为0.67,0.54,P<0.01),GD组IL-4与TRAb正相关(r=0.71,P<0.01)。Th1/Th2细胞因子失衡反映了AITD的病理改变和免疫功能紊乱,与甲状腺自身抗体检测相结合可成为AITD辅助诊断的指标。

To study the diagnostic value of Th1/Th2 cell cytokine and thyroid autoantibody in autoimmune thyroid diseases（AITD）,28 patients with Graves＇ disease（GD）,15 patients with hyperthyroidism and thyroiditis（GDIII）,13 patients with Hashimoto＇s hyperthyroidism（HTL）,21 patients with Hashimoto＇s thyroiditis（HT）and 20 healthy subjects were enrolled in this study.The serum concentrations of Th1 cytokine（IFN-γ） and Th2 cytokine（IL-4） were determined by ELISA.The serum levels of thyrotropin receptor antibodies（TRAb）,thyroglobulin antibodies（TGAb） and thyroid peroxidase antibodies（TPOAb） were measured by RIA.The relationship between the serum levels of IFN-γ,IL-4 and TRAb,TGAb and TPOAb were analyzed.The results showed that IFN-γ levels from higher to lower in different groups were in the order of HT,HTL,GDIII,GD and the IL-4 were GD,GDIII,HTL,HT,respectively.There was significant difference in the IFN-γ（P〈0.05） and IL-4 levels（P〈0.01）between GDIII and HTL groups.There was no significant difference in TGAb and TPOAb between GDIII and HTL groups.In HT group,IFN-γ levels was positively correlated with TGAb and TPOAb（r=0.67,0.54,P〈0.01）.In GD group,IL-4 was positively correlated with TRAb（r=0.71,P〈0.01）.The imbalance of Th1/Th2 cell cytokine reflects pathologic change and abnormality of immune function in AITD patients.The detection of Th1/Th2 cell cytokine combined with thyroid autoantibody may be regarded as an indicator in the diagnosis of autoimmune thyroid diseases.