摘要
目的探讨细胞因子TNF-α和IL-6与Graves病发病的关系及其临床意义。方法选取160例Graves病患者为研究对象,随机分为单纯131I治疗组(78例)和联合治疗组(131I+碳酸锂)(82例),同时选取70例健康体检者作为对照组。采用酶联免疫吸附法(ELISA)检测对照组及治疗组治疗前及治疗后3、6、12个月的甲状腺功能指标(FT3、FT4、TSH、TRAb)及细胞因子(TNF-α、IL-6)水平,并评价TNF-α和IL-6与甲状腺功能指标的相关性。结果与对照组比较,Graves病患者治疗前血清FT3、FT4及TRAb水平明显升高(P<0.05),而TSH水平明显降低(P<0.05),同时其血清细胞因子TNF-α和IL-6水平也显著升高(P<0.05);与治疗前比较,治疗后3、6、12个月上述各项指标均得到了明显改善;其中,联合治疗组较单纯131I治疗组改善更明显(P<0.05)。相关性分析显示,Graves病患者治疗前及单纯131I治疗后3、6、12个月,血清TNF-α与TRAb成正相关(r=0.852、0.745、0.683、0.732,P<0.05);Graves病患者治疗前及联合治疗后3、6、12个月,血清TNF-α与TRAb成正相关(r=0.972、0.853、0.658、0.682,P<0.05),同时治疗后血清IL-6与TRAb也成正相关(r=0.823、0.783、0.792,P<0.05)。结论 Graves病患者血清TNF-α和IL-6水平与甲状腺功能密切相关,可作为评判Graves病患者131I联合碳酸锂治疗效果的临床指标。
Objective To investigate the changes of serum cytokines in patients with Graves disease before and after 131 I combined with lithium carbonate treatment,and explore the relationship of cytokine in the incidence of Graves disease.Methods 160 patients with Graves disease were enrolled in the study,who were randomly divided into 131 I treatment group（78cases）and combined treatment group（131I＋lithium carbonate）（82cases）,and 70 healthy subjects were included as control group.The thyroid function parameters（FT3、FT4、TSH、TRAb）and cytokines（TNF-α、IL-6）in control group and treatment group before and 3,6,12 months after treatment were measured by enzyme-linked immunosorbent assay（ELISA）,and the correlation between the cytokines and thyroid function parameters were assessed.Results Compared with the control group,serum levels of FT3,FT4 and TRAb were significantly higher,and TSH was lower,meanwhile,cytokines levels including TNF-αand IL-6 were higher in patients with Graves disease before treatment（P〈0.05）;In 3,6and 12 months after treatment,the above mentioned indexes were significantly improved,but the effects of combined treatment group were better than 131 I treatment alone group（P〈0.05）.The correlation analysis showed that the serum level of TNF-αand TRAb was positively correlated with before and 3,6and 12 months after 131 I alone treatment（r=0.852,0.745,0.683,0.732,P〈0.05）;serum level of TNF-αand TRAb was positively correlated with before and 3,6and 12 months after combined treatment（r=0.972,0.853,0.658,0.682,P〈0.05）;meanwhile,serum level of IL-6and TRAb was positively correlated with 3,6and 12 months after combined treatment（r=0.823,0.783,0.792,P〈0.05）.Conclusion The levels of cytokines were correlated with thyroid function in patients with Graves disease,which might be a clinical indicator to evaluate the therapeutic efficacy of Graves disease after 131 I combined with lithium carbonate treatment.
出处
《成都医学院学报》
CAS
2015年第3期350-353,共4页
Journal of Chengdu Medical College
