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甲状腺素体外对Graves病T B细胞功能异常影响的研究 |
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刘 铭 潘菊芬 白 虹 冯 凭 尹 潍
中国图书分类号 R392.6
摘 要 目的：探讨Graves病(GD)患者异常升高的甲状腺激素与免疫异常之间的因果关系，和抗甲抗腺药治疗GD期间加用甲状腺素(T4)的作用。方法：将GD患者外周血单个核细胞(PBMC)在不同浓度的T4条件下体外培养6 d后，检测T细胞亚群和培养上清中可溶性白细胞介素2受体(sIL-2R)及IgG的含量。结果：与正常对照组相比培养后的GD患者PBMC中CD8+T细胞亚群百分率明显减少(P＜0.01)；培养上清中sIL-2R及IgG水平显著升高(P＜0.01)；T4体外对上述指标无明显影响。结论：GD患者同时具有T、B细胞异常；T4体外对GD患者的T、B细胞功能异常无影响，异常升高的甲状腺激素可能为GD患者免疫异常的结果而不是导致免疫异常的原因。
关键词 Graves病 甲状腺素 T淋巴细胞 B淋巴细胞
The study of the effect of thyroxine on T，B cells abnormalities in graves disease patients
LIU Ming, PAN Ju-Fen, BAI Hong et al.
Department of Endocrinology, Tianjin Medical University Hospital, Tianjin 300052
Abstract Objective: To clarify whether there are T,B cells abnormalities in Graves disease(GD) patients and the relationship between those abnormalities and thyroxine(T4), further investigate the effect of T4 administration on the risk of relapse of hyperthyroidism during antithyroid drug therapy. Methods: Peripheral blood mononuclear cells(PBMC) of GD patients and nomal individuals were incubated at absent or present of different concentration of T4. The supernatant of cell cultured were used for detecting IgG and sIL-2R and cell pellet were asayed for detecting PBMC surface CD molecules. Results: In GD patients, the percentage of CD8+ T subset was decreased and CD4+/CD8+ cell ratio and the level of sIL-2R and IgG were increased (P＜0.01). T4 had no effect on above parameters(P＜0.05). Conclusion： There are not only B cell but also T cell function abnormalities in GD patients. The fact that T4 had no effect on T,B function in vitro infer that the excessive thyroxine is outcome but not the reason of T,B abnormal in GD patients.
Key words Graves disease Thyroxine T lymphocyte B lymphocyte
Graves病(GD)是一种器官特异性自身免疫性疾病，其免疫学发病机理尚示完全被揭示。有研究发现，GD患者在应用抗甲状腺药物(ATD)治疗期间，随着甲状腺功能的恢复，其异常免疫功能也转向恢复，它们之间的因果关系至今尚无定论［1］；同时，近些年来有研究显示，在ATD治疗期间，加用甲状腺素(T4)可显著降低GD病人自身抗体滴度，减低停药后的复发率［2］。因此[1] [2] [3] 下一页
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