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目的:本研究主要通过检测初发GD患者治疗前后外周血核因子NF-κB、超敏CRP(us-CRP)水平活性,以探讨其在Graves病免疫病理机制中的意义。方法:于治疗前及治疗后2月分别采集患者静脉血测定NF-κB和超敏CRP的含量。NF-κB采用ELISA法测定、超敏CRP采用免疫散射比浊法。结果:1.58例GD患者活动期(治疗前)NF-κB水平显著升高,与正常对照组相比差别有统计学意义(P<0.001)。治疗后明显下降,但仍高于对照组(P<0.001)。2.GD患者外周血NF-κB与甲状腺素水平作线性相关分析,58例GD患者治疗前后NF-κB水平变化与FT3治疗前后变化呈正相关(r=0.572,P<0.001),与FT4相关性不大(r=0.020,P>0.05),而治疗前后与TSH相关性也不大(r=0.128,P>0.05)。3.GD患者治疗前us-CRP水平显著升高,与正常对照组相比差别有显著性(P<0.001)。治疗后明显下降,但仍高于对照组(P<0.001)。4.应用PTU及他巴唑治疗的GD患者治疗前及治疗后的NF-κB、us-CRP差别均无统计学意义(P>0.05)。结论:GD患者活动期外周血核转录因子NF-κB、us-CRP水平明显升高,说明核转录因子NF-κB与us-CRP在GD免疫病理机制中很可能起着重要作用。
Objective: The purpose of this study is to detect the levels of NF-κB and us-CRP in peripheral blood of patients with primary GD before and after treatment to explore its significance in the immunopathogenesis of Graves disease. Methods: Venous blood samples were collected before treatment and 2 months after treatment to determine the content of NF-κB and hypersensitive CRP. NF-κB was measured by ELISA and hypersensitive CRP by immune nephelometry. Results: In 1.58 GD patients, the level of NF-κB in active stage (before treatment) was significantly higher than that in normal control group (P <0.001). After treatment decreased significantly, but still higher than the control group (P <0.001). There was a positive correlation between the level of NF-κB and the level of NF-κB in 58 GD patients before and after FT3 treatment (r = 0.572, P <0.001) (R = 0.020, P> 0.05), while the correlation between TSH and before treatment was not significant (r = 0.128, P> 0.05). The levels of us-CRP in patients with GD before treatment were significantly higher than those in normal controls (P <0.001). After treatment decreased significantly, but still higher than the control group (P <0.001). There was no significant difference in NF-κB and us-CRP before and after treatment between GD patients treated with PTU and methimazole (P> 0.05). CONCLUSIONS: The levels of NF-κB and us-CRP in peripheral blood of GD patients are significantly increased, indicating that nuclear factor NF-κB and us-CRP may play an important role in the mechanism of GD immunopathology.