Graves病患者治疗前后血清TNF-α和IL-6的动态变化

Dynamic Changes of Serum Levels of Interleukin-6 and Tumor Necrosis Factor-α in Graves' Disease Patients with Antithyroid Drug Therapy

目的 :检测Graves病(GD)患者治疗前后血清白细胞介素 -6(IL -6)和肿瘤坏死因子(TNF-α)的动态变化 ,探讨细胞因子与GD发生发展之间的内在联系。方法 :于治疗前和治疗后8周与24周采集患者静脉血 ,分别采用放免法和超敏酶免法检测血清IL -6和TNF -α含量。结果 :GD患者血清IL -6和TNF -α水平明显升高 ;应用抗甲状腺药物8周和24周甲状腺激素恢复正常后 ,IL -6和TNF-α亦进行性下降 ,但仍然高于正常对照组。TNF-α以及IL-6水平与血清甲状腺激素浓度无明显相关关系 ,但IL -6 -TSH受体抗体显著正相关。结论 :IL-6和TNF -α的异常与GD的发生发展密切关联。患者的免疫缓解明显滞后于功能缓解。

Objective To study the relationship between the cell factors (interleukin-6 and tumor necrosis factor-α)and development of Graves' disease (GD) through measurement of their level changes during drug treatment. Method Serum IL 6 and TNF-α levels were determined with ultrasensitive ELISA and RIA before starting antithyroid drug therapy and at 8 and 24 weeks afterwards. Results serum concentrations of IL-6 and TNF-α were significantly elevated in GD patients before starting treatment and gradually decreased of 8 and 24 weeks after treatment, though still higher than those of normal control subjects. No statistical correlation was found between IL-6, TNF-α and thyroid hormones levels. however, the concentration of IL-6 was positively correlated with serum level of thyrotropin receptor antibody (TRAB). Conclusions IL-6 and TNF-α might play important roles in the pathogenesis and progression of GD. The immunal remission in patients with GD is much slower than the functional remission.