血清sICAM-1及透明质酸与糖皮质激素治疗TAO敏感性关系的研究

Study on association of sICAM-1 and hyaluronic acid with sensitivity of glucocorticoid therapy in patients with thyroid-associated ophthalmopathy

目的探讨血清可溶性细胞间黏附分子-1(soluble intercellular adhesion molecule1,sICAM-1)及透明质酸(hyaluronic acid,HA)与甲状腺相关眼病(thyroid-associated ophthalmopathy,TAO)糖皮质激素治疗敏感性的关系。方法 41例(74眼)活动期TAO患者给予糖皮质激素治疗,根据疗效将患者分为治疗有效组和无效组,观察治疗前后血清sICAM-1及HA的水平变化。结果治疗有效组58眼,治疗前患者血清sICAM-1及HA平均含量分别为(1136.2±162.5)μg·L-1、(124.8±61.4)μg·L-1,治疗后两者的含量分别为(829.7±94.6)μg·L、(81.5±33.9)μg·L-1,均较治疗前显著下降(P=0.000、P=0.001)。治疗无效组16眼,血清sICAM-1水平治疗后(1209.1±136.2)μg·L-1较治疗前(1078.6±120.3)μg·L-1有所上升(P=0.046),HA的水平治疗后(112.7±51.4)μg·L-1较治疗前(126.5±63.8)μg·L-1变化较小(P=0.623)。有效组治疗后血清sICAM-1、HA水平均低于无效组(P=0.000、P=0.037);治疗前两组水平差异均无统计学意义(P=0.338、P=0.841)。结论 TAO患者血清sICAM-1及HA水平的变化与糖皮质激素治疗的敏感性密切相关,可作为评价糖皮质激素治疗效果的指标。

Objective To investigate the association of soluble intercellular adhesion molecule-1（sICAM-1） and hyaluronic acid（HA） with the sensitivity to glucocorticoid therapy in thyroid-associated ophthalmopathy（TAO） patients.Methods A total of 41 cases（74 eyes） with active TAO were treated with glucocorticoid.According to the treatment effect,patients were divided into effective group and ineffective group.Before and after glucocorticoids treatment,the serum content of sICAM-1 and HA of two groups were compared.Results In the effective group,serum levels of sICAM-1 and HA were（1136.2±162.5）μg·L-1 and（124.8±61.4）μg·L-1 before treatment;The levels of sICAM-1 and HA were significantly decreased to（829.7±94.6）μg·L-1 and（81.5±33.9）μg·L-1 after treatment（P=0.000;P=0.001）.In the ineffective group,serum level of sICAM-1 was（1209.1±136.2）μg·L-1 after treatment,which higher than（1078.6±120.3）μg·L-1 after treatment（P=0.046）,and HA level was（112.7±51.4）μg·L-1 after treatment,which did not have obvious change compared with（126.5±63.8）μg·L-1 before treatment（P=0.623）.In effective group,the serum level of sICAM-1 and HA were lower than those of ineffective group after treatment（P=0.000,P=0.037）,while no difference was found before treatment（P=0.338,P=0.841）.Conclusions The variations of sICAM-1 and HA levels are closely correlated with the sensitivity to glucocorticoid therapy in TAO patients,so they can be used as the indexes to evaluate therapeutic sensitivity to glucocorticoid therapy in TAO patients.