[1]赵永强,田德增,魏晓华,等.不同治疗方法对Graves病患者外周血淋巴细胞亚群的影响[J].国际内分泌代谢杂志,2015,(04):234-237,241.[doi:10.3760/cma.j.issn.1673-4157.2015.04.005]
　Zhao Yongqiang*,Tian Dezeng,Wei Xiaohua,et al.Effects of different therapeutic methods on peripheral blood lymphocyte subgroups in patients with Graves' disease[J].International Journal of Endocrinology and Metabolism,2015,(04):234-237,241.[doi:10.3760/cma.j.issn.1673-4157.2015.04.005]
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不同治疗方法对Graves病患者外周血淋巴细胞亚群的影响()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
期数:
2015年04
页码:
234-237,241
栏目:
论著
出版日期:
2015-07-20

文章信息/Info

Title:
Effects of different therapeutic methods on peripheral blood lymphocyte subgroups in patients with Graves' disease
作者:
赵永强; 田德增; 魏晓华; 陈瑞锋; 王升; 陈贵存; 高用琴; 王利强
455000　河南省安阳地区医院内分泌科（赵永强，田德增，魏晓华，高用琴），心内科（陈瑞锋），临床试验室（王升），输血科（陈贵存），核医学科（王利强）
Author(s):
Zhao Yongqiang*; Tian Dezeng; Wei Xiaohua; Chen Ruifeng; Wang Sheng; Chen Guicun; Gao Yongqin; Wang Liqiang.
*Department of Endocrinology，Anyang District Hospital，Anyang 455000，China
关键词:
Graves病; 甲状腺功能; 淋巴细胞亚群
Keywords:
Graves' disease; Thyroid function; Lymphocyte subgroups
DOI:
10.3760/cma.j.issn.1673-4157.2015.04.005
摘要:
目的　探讨抗甲状腺药物、131I、外科手术对Graves病患者外周血淋巴细胞亚群的影响。方法　选取106例符合Graves病诊断的门诊及住院患者，根据患者实际情况分为抗甲状腺药物组（39例）、131I治疗组（48例）、甲状腺次全切除术组（19例），于治疗前及治疗后3、6、12个月采用化学发光免疫仪检测游离T3、游离T4、促甲状腺激素（TSH）水平。电化学发光仪检测TSH受体抗体（TRAb）。流式细胞术检测CD3+、CD3+ CD4+、CD3+CD8+、CD3/(CD16+CD56+）、CD3-CD19+等水平。结果　治疗后3个月，与其他两组相比，甲状腺次全切除术组游离T3、游离T4、TRAb水平降低，TSH水平升高（F =52.95~126.81，P均＜0.05）。治疗后6个月，131I治疗组与抗甲状腺药物组相比，游离T3水平有降低趋势，但无统计学意义（P ＞0.05）， 游离T4、TSH无明显差异（P均 ＞0.05），而TRAb水平的变化有统计学意义（F =42.69，P ＜0.05）。治疗后12个月，各治疗组游离T3、游离T4、TSH、TRAb趋向正常水平。治疗前，3组患者CD3+、CD3+ CD4+、CD3+CD8+、CD4+/ CD8+、CD3/（CD16+CD56+）、CD3-CD19+的差异无统计学意义。治疗后各时间点，与其他两组相比，甲状腺次全切除术组CD3+、CD3+ CD4+、CD3+CD8+、CD4+/ CD8+水平均最低（F =3.48~68.28，P均＜0.05）；与抗甲状腺药物组相比，治疗3个月后，131I治疗组CD3+、CD3+CD4+、CD3+CD8+、CD4+/ CD8+、CD3-CD19+明显升高（F =13.85~68.28，P均＜0.05），随着治疗时间的延长各指标逐渐降低。相关性分析表明，游离T3、游离T4、TRAb与CD3+（r =0.319，0.402， 0.426，P均＜0.01）、 CD3+CD4+（r =0.467，0.526，0.453，P均＜0.01）、CD3-CD19+（r =0.493，0.462，0.241，P ＜0.01）呈正相关，与CD3+CD8+（r =-0.422，-0.523，-0.344，P均＜0.01）、CD3（CD16+CD56+）（r =-0.597，-0.543，-0.487，P均＜0.01）呈负相关。TSH与CD3+CD8+、CD3（CD16+CD56+）（r =0.436，0.474，P均＜0.01）呈正相关，与CD3+、CD3+CD4+、CD3-CD19+（r =-0.360，-0.522，-0.530，P均＜0.01）呈负相关。结论　不同的治疗方法对Graves病患者外周淋巴细胞亚群产生不同的影响，检测外周淋巴细胞亚群的水平对Graves病的治疗有一定的指导意义。
Abstract:
Objective　To explore the influences of anti-thyroid drug ，131I and surgery on peripheral blood lymphocyte subgroups in patients with Graves' disease. Methods　A total of 106 inpatients and outpa-tients with Graves' disease were included. According to their therapeutic method of Graves' disease，patients were divided into 3 groups：39 patients in anti-thyroid drug therapy group，48 patients in 131I therapy group，19 patients in surgery therapy group. Before and 3，6，12 months after treatment，free T3， free T4，and thyroid stimulating hormone （TSH） were tested by chemiluminescence immunoassay，TSH receptor antibody（TRAb） was tested by electro-chemiluminescence immunoassay and CD3+，CD3+CD4+，CD3+CD8+，CD3/（CD16+CD56+），CD3-CD19+ were tested by flow cytometry. Results　After treatment for 3 months，compared with anti-thyroid drug therapy group and 131I therapy group，levels of free T3，free T4，TRAb in surgery therapy group were decreased，but level of TSH was increased（F =52.95-126.81，all P＜0.05）. After treatment for 6 months，compared with anti-thyroid drug therapy group，levels of free T3 in 131I therapy group was decreased，although without statistical significance（P ＞0.05） ；level of free T4 and TSH had no significance（all P ＞0.05），whereas TRAb was different（F =42.69，P＜0.05）. After treatment for 12 months，free T3，free T4，TSH and TRAb in three groups were gradually returned to normal. Before treatment，there were no differences of CD3+，CD3+CD4+，CD3+CD8+，CD4+/CD8+，CD3/（CD16+CD56+），CD3-CD19+ between the three groups. After treatment，the levels of CD3+，CD3+ CD4+，CD3+CD8+，CD4+/ CD8+ in surgery therapy group were lower than those in other groups（F =3.48-68.28，all P＜0.05）. After treatment for 3 months，compared with anti-thyroid drug therapy group，CD3+，CD3+CD4+， CD3+CD8+，CD4+/ CD8+，CD3-CD19+ in 131I therapy group were increased greatly （F =13.85-68.28，all P ＜0.05）. However，all those markers were decreased gradually. The correlation analysis showed that free T3，free T4 and TRAb were positively correlated with CD3+（r =0.319，0.402，0.426，all P ＜0.01），CD3+CD4+（r =0.467，0.526，0.453，all P ＜0.01），CD3-CD19+（r =0.493， 0.462，0.241，all P ＜0.01），but negatively correlated with CD3+CD8+（r =-0.422，-0.523，-0.344，all P ＜0.01），CD3（CD16+CD56+）（r =-0.597，-0.543，-0.487，all P ＜0.01）. TSH was positively correlated with CD3+CD8+，CD3（CD16+CD56+） （r =0.436，0.474，all P ＜0.01），but negatively correlated with CD3+，CD3+CD4+ and CD3-CD19+（r =-0.360， -0.522，-0.530，all P ＜0.01）. Conclusions　The different therapeutic methods have different impacted on peripheral blood lymphocyte subgroups in patients with Graves' disease. Detecting peripheral blood lymphocyte subgroups have a certain significance for treating Graves' disease.

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更新日期/Last Update: 2015-07-20