左甲状腺素对桥本氏甲状腺炎患者辅助性T淋巴细胞的影响

Effects of Levothyroxine on the Follicular Helper T Lymphocyte Level of Patients with Hashimoto's Thyroiditis

目的:探讨左甲状腺素对桥本氏甲状腺炎患者辅助性T淋巴细胞的影响。方法:选择51例桥本氏甲状腺炎患者作为左甲状腺素组,另同期选择30名健康人作为对照组。左甲状腺素组患者给予左旋甲状腺素钠片25~50μg,口服,每日1次,根据甲状腺功能调整用药剂量,待甲状腺功能正常后,以此剂量维持治疗,连用90 d。观察左甲状腺素组患者治疗前后游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)水平和Th17细胞占外周血CD4^+T细胞百分率(Th17/CD4^+),并与对照组进行比较,分析Th17/CD4^+与甲状腺功能的相关性。结果:治疗后,左甲状腺素组患者Th17/CD4^+显著低于同组治疗前,但高于对照组,差异均有统计学意义(P<0.05);TSH水平显著低于同组治疗前,FT3、FT4水平均显著高于同组治疗前,差异均有统计学意义(P<0.05),但与对照组比较差异均无统计学意义(P>0.05)。左甲状腺素组患者Th17/CD4^+与甲状腺功能具有正相关性(r=0.815,P<0.05)。结论:左甲状腺素可显著降低桥本氏甲状腺炎患者的Th17/CD4^+、TSH水平,升高FT3、FT4水平,且Th17/CD4^+与桥本氏甲状腺炎的发生发展具有相关性。

OBJECTIVE： To explore the effects of levothyroxine on the follicular helper T lymphocyte level of patients with Hashimoto＇s thyroiditis. METHODS： 51 patients with Hashimoto＇s thyroiditis were selected as levothyroxine group, and another 30 healthy people were control group. Levothyroxine group was orally given 25-50 ug Levothyroxine sodium tablet, once a day, the dose was adjusted based on thyroid fimction, and the dose maintained when thyroid function turned normal, for continuous 90 d. Free triiodothyronine （FT3）, free thyroxine （FT4）, thyroid stimulating hormone （TSH） and the percentage of Thl7 cells account- ed for peripheral blood CD4~ T cells （Th17/CD4~） in levothyroxine group before and after treatment were observed and compared with control group, the correlation of Thl7/CD4~ and thyroid function. RESULTS： After treatment, Th17/CD4＋ level in levothyrox- ine group were significantly lower than before and higher than control group, the differences were statistically significant（P〈0.05）. TSH in levothyroxine group were significantly lower than before, FT3 and FT4 were significantly higher than before, the differenc- es were statistically significant（P〈0.05） ; compared with control group, the differences were not statistically significant（P〉0.05）. Thl7/CD4＋ showed positive correlation with thyroid function in levothyroxine group. CONCLUSIONS： Levothyroxine can signifi- cantly reduce the Thl7/CD4＋ and TSH, increase FT3 and FT4, and Th17/CD4＋ is involved in the occurrence and progression of Hashimoto＇ s thyroiditis.