儿童Graves病IFN-γ/IL一4水平失衡及意义

The imbalance and its significance of levels of IFN -γ/IL - 4 in children with Graves' disease

采用ＥＬＩＳＡ法对４２例Ｇｒａｖｅｓ病病儿细胞因子失衡及其与发病的关系进行研究。结果：（１）与正常组相比，初诊组ＩＦＮ－γ水平、ＩＦＮ－γ／ＩＬ－４比值明显升高，ＩＬ－４水平明显降低（Ｐ＜０．００１或０．００２）；ＩＦＮ－γ抗体阳性组与阴性组相比；ＩＦＮ－γ水平、ＩＦＮ－γ／ＩＬ－４比值明显降低（Ｐ＜０．０５），而ＩＬ－４水明显升高（Ｐ＜０．００１）；且ＩＦＮ－γ／ＩＬ一４比值与血清Ｔ３和Ｔ４水平呈显著正相关（ｒ＝０．５４、０．５６和０．５５、０．６３，Ｐ＜０．０５）；（２）复诊组中，治疗效果好组ＩＦＮ一γ水平、ＩＦＮ－γ／ＩＬ－４比值明显降低（Ｐ＜０，０５），ＩＬ－４水平无明显变化（Ｐ＜０．０５）；而治疗效果差组细胞因子水平无显著变化（Ｐ＞０．０５）。提示：Ｇｒａｖｅｓ病体内存在以Ｔｂ１类占优势的细胞因子水平的失衡；抗体阳性病儿其细胞因子类型向Ｔｈ２转化；异常的细胞因子可导致甲状腺功能受损；细胞因子的监测对于Ｇｒａｖｅｓ病的病情估价、协助诊断及判断预后有一定的指导意义。

The imbalance of cytokines and its relationship to development of Grave's disease(GD) were investigated in 42 children with GD. The results showed:(1)The levels of IFN - γ and the ratios of IFN -γ/IL - 4 were significantly increased. but IL- 4 was significantly decreased in first visit groups compared with normal controls(P<0.001 or 0.002);Comparing antibody - positive with negative group, the levels of IFN -γ , and the ratios of IFN - γIL - 4 were significantly decreased(P< 0.05). IL - 4 was significantly increased(P< 0.001);The IFN -γ ratios of IFN -γ/IL - 4 were positively correlated with individual serum T3 and T4 levels(r= 0.54, 0.56 and 0.55、0.63 respectively , P<0.05).(2) As far as further consultion children are concerned , in good theraputic effect groups, the levels of IFN-γ, and the ratios of IFN-γ/IL- 4 were markedly lower(P<0.05) .but IL -4 was unchanged(P>0.05);But in poor therapeutic effect groups . the levels of cytokines was unchanged(P>0.05). The present study demonstrates that the levels of cytokines were dislocated , which showed that Thl type was dominant and could play a major role in the development of Grave ' s disease. But , the cytokine type of antibody - positive children began shifting to Th2 type. The detection of cytokine levels would be used for evaluating state, and diagnosing prognosis of illness.