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目的 :探讨IFN γ,IL 4 ,IL 1 8在Graves’病 (GD)发病机制中的作用及相互关系和GD免疫动态 .方法 :用酶联免疫吸附法 (ELISA法 )检测 4 0例初发GD患者及其中 38例治疗后患者和 30例正常人血清中IFN γ,IL 4和IL 1 8水平 .结果 :①初发GD患者与正常组比较 ,血清IFN γ,IL 4 ,IL 1 8水平及IFN γ/IL 4比值均显著升高 (P <0 .0 1 ) .②治疗后GD患者与初发GD患者比较 ,血清IFN γ 水平无差异(P >0 .0 5 ) ,血清IL 4水平显著升高 (P <0 .0 1 ) ;血清IL 1 8水平及IFN γ/IL 4比值降低 (分别为P <0 .0 5 ,P <0 .0 1 ) .治疗后GD患者与正常组比较 ,血清IFN γ,IL 4水平显著升高 (P <0 .0 1 ) ,IL 1 8升高 (P <0 .0 5 ) ,血清IFN γ/IL 4比值显著下降 (P <0 .0 1 ) .③初发GD患者血清中IFN γ 与IL 1 8之间呈直线正相关 (r =0 .6 77,P <0 .0 5 ) ;治疗后GD患者血清中IL 4与TT3,TT4之间呈直线负相关 (r =- 0 .6 78,-0 .6 2 6 ,P <0 .0 5 ) ,血清中IL 1 8与TT3,TT4之间呈直线正相关 (r =0 .6 0 1 ,0 .5 35 ,P <0 .0 5 ) .结论 :GD患者血清中IFN γ,IL 4和IL 1 8水平的变化可能在GD的发病机制中起重要作用 ,初发GD以Th1型免疫反应为主 ,抗甲状腺药物治疗后则向Th2型漂移 .
Objective: To investigate the role and relationship of IFN γ, IL 4 and IL 18 in the pathogenesis of Graves’ disease (GD) and the dynamics of GD immunization.Methods: 40 cases of primary GD, IFN-γ, IL-4 and IL-18 levels in serum of 38 patients and 30 normal controls.Results: ①The serum levels of IFN-γ, IL-4, IL- (P <0.01) .②After treatment, there was no difference in serum IFN-γ between GD patients and newly diagnosed GD patients (P> 0.05), serum IL-4 (P <0.01, P <0.01), and the level of serum IL-8 and the ratio of IFNγ / IL-4 decreased (P0.05, P0.01 respectively) Serum levels of IFN-γ and IL-4 were significantly increased (P <0.01), IL-8 was increased (P <0.05), serum IFN-γ / IL4 ratio was significantly decreased (P < There was a linear positive correlation between IFNγ and IL-8 in serum of newly diagnosed GD patients (r = 0.677, P0.05). After treatment, the levels of IL-4 and TT3, TT4 was linearly negative correlation (r = - 0.678, -0.626, P <0.05), serum IL18 and TT3, TT4 was straight (R = 0.601,0.535, P <0.05) .Conclusion: The changes of serum IFN-γ, IL-4 and IL-18 levels in GD patients may play a role in the pathogenesis of GD An important role in the initial GD to Th1-based immune response, anti-thyroid drug treatment to Th2-type drift.