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目的:提供自身免疫甲状腺病(AITD)患者体内Th1/Th2平衡紊乱的依据。方法:应用酶联免疫吸附法(ELISA)测定27例Graves病(GD)、24例甲状腺功能正常的桥本甲状腺炎(HT)、25例甲状腺功能低下的HT患者及20例正常对照者血清中IL12和IL18的浓度,并检测GD患者的甲状腺刺激性抗体。结果:GD患者与甲状腺功能正常的HT患者血中IL12、IL18水平无明显差异,但均高于正常对照者的相应水平。甲状腺功能低下的HT患者血中IL12和IL18的水平与正常对照者无差异。在GD和甲功正常的HT,IL18与IL12呈明显正相关。在GD,IL12和IL18均与其甲状腺刺激性抗体(TSAb)活性呈正相关。在甲状腺功能正常的HT还存在IL12和IL18二者与甲状腺球蛋白抗体(TgAb)的显著性正相关。结论:提示Th1型细胞在GD和HT两种AITD的发病中均起重要作用。通过抑制Th2型免疫反应,促进向Th1型的转变来治疗GD时,有可能导致病情恶化。
OBJECTIVE: To provide a basis for the Th1 / Th2 balance disorder in patients with autoimmune thyroid disease (AITD). Methods: 27 cases of Graves’ disease (GD), 24 cases of Hashimoto’s thyroiditis (HT) with normal thyroid function, 25 cases of hypothyroidism HT and 20 normal controls were detected by enzyme-linked immunosorbent assay (ELISA) IL12 and IL18 concentration, and thyroid stimulating antibodies in GD patients. Results: There was no significant difference in the levels of IL12 and IL18 between GD patients and HT patients with normal thyroid function, but both were higher than those of normal controls. The levels of IL12 and IL18 in the blood of hypothyroid patients with HT were not different from those of normal controls. In GD and normal thyroid HT, IL18 was positively correlated with IL12. There was a positive correlation between GD, IL12 and IL18 in thyroid stimulating antibody (TSAb) activity. There is also a significant positive correlation between both IL12 and IL18 with thyroglobulin antibody (TgAb) in HT with normal thyroid function. Conclusion: It suggests that Th1 cells play an important role in the pathogenesis of both AITD and GD. The treatment of GD by inhibiting the Th2-type immune response and promoting the Th1-type transition may result in worsening of the disease.