雷公藤多苷短程治疗对桥本病甲状腺组织T细胞亚群的影响

Effects of short-term treatment of Tripterygium w ilfordii polyglycosidium on T-lymphocyte subsets in thyroid tissue of Hashimoto's disease

目的观察雷公藤多苷(TWP)短期治疗对桥本病甲状腺组织中T细胞亚群等免疫学指标的影响。方法 60例桥本病患者随机平均分为2组,对照组根据甲状腺功能选用左旋甲状腺素钠或赛治治疗;雷公藤多苷组在对照组的基础上加服TWP。观察随访3个月,比较两组甲状腺组织中T细胞亚群:总T淋巴细胞(CD3+)、调节性T细胞(Treg细胞)(CD4+CD25+)、辅助性T细胞(Th细胞)(CD3+CD4+)、总B淋巴细胞(CD3-CD19+)、细胞毒T淋巴细胞(CD3+CD8+)百分比变化,淋巴细胞的浸润程度及外周血甲状腺球蛋白抗体(TG-Ab)、甲状腺过氧化物酶抗体(TPO-Ab)、促甲状腺激素受体抗体(TRAb)水平的差异。结果雷公藤多苷组:①甲状腺组织中CD3+总T淋巴细胞、CD3+CD4+辅助性T细胞较治疗前下降(P均<0.05),低于对照组(P均<0.05);CD3+CD8+细胞毒T淋巴细胞、CD4+CD25+调节性T细胞较治疗前升高(P均<0.05),高于对照组(P均<0.05)。②甲状腺组织内重度淋巴细胞浸润例数较治疗前明显下降(P<0.05),低于对照组(P<0.05);③外周血TRAb转阴患者数较治疗前显著增高(P<0.05),高于对照组(P<0.05);TG-Ab及TPO-Ab的水平较治疗前明显下降(P<0.05),低于对照组(P均<0.05)。结论 TWP短期治疗对桥本病甲状腺组织中T细胞亚群的分布有显著的调节作用,同时能降低甲状腺组织中淋巴细胞的浸润及自身免疫性抗体的水平。

Objective To observe the effects of short-term treatment of Tripterygium wilfordii polyglycosidium （TWP） on T-lymphocyte subsets in thyroid tissue of Hashimoto＇s disease. Methods A total of 60 patients with Hashimoto＇s disease were randomly divided into 2 groups ： the control group （ n = 30） receiving levothyroxine sodium or thyrozol, and the TWP group （ n = 30） treated with TWP besides levothyroxine sodium or thyrozol. After 3-month treatment, the changes of T-lymphocyte subsets were observed and compared, including the total T-lymphocytes （ CD3^＋ ）, regulatory T cells （ CD4^＋ CD25 ＋ ）, helper T-cell （ CD3^＋ CD4^＋ ）, total B-lymphocytes （ CD3^- CD19^＋ ）, cytotoxic T lympho- cytes （ CD3^＋ CD8^＋ ）, the degree of lymphocytic infiltrates, TG-Ab, TPO-Ab and TRAb. Results After the treatment of TWP, the numbers of CD3^＋ T ceils and CD3^＋ CD4^＋ Treg cells reduced （ P 〈 0.05 ）, and were significantly lower than those of the control group after treatment （ P 〈 0.05 ） ; the numbers of CD4^＋ CD25^＋ regulatory T ceils and CD3^＋ CD8 ^＋ cytotoxic T lymphocytes increased （ P 〈 0.05 ）, and were significantly higher than those of the control group after treatment （ P 〈 0.05 ）. Lymphocyte infiltration in the thyroid reduced （ P 〈 0.05 ）, and was less than that of the control group （ P 〈 0.05 ）. Three kinds of antibodies of the TWP group had declined more significantly than those of the control group （P 〈 0.05）. Conclusion TWP short-term treatment has obvious immunomodulatory effects on im- proving the distribution of T-lymphocyte subsets, lymphocyte infiltration and autoimmune thyroid antibodies.