妊娠合并Graves病T淋巴细胞亚群及甲状腺抗体检测的临床研究

目的 观察妊娠合并Graves病患者T淋巴细胞亚群及甲状腺抗体变化，探讨其免疫紊乱特征。方法 采用流式细胞仪测定32例初诊Graves病人、31例妊娠合并初诊Graves病人及28例正常对照者的T淋巴细胞亚群CD3＋、CD4＋、CD8＋、CD4＋／CD8＋，并用放射免疫法测定三组的TSAb、TGAb和TMAb。结果 妊娠合并初诊Graves病组的CD3＋为（62．72±6，13）％，CD4＋为（34．24±4．16）％，CD8＋为（33．26±3．71）％，CD4＋／CD8＋为（1、22±0．34）％。妊娠合并初诊Graves病组的TSAb20％，TGAb38％，TMAb32％.初诊Graves病组及妊娠合并初诊Graves病组与正常对照组比较，CD3＋、CD4＋、CD4＋／CD8＋下降，差异均有统计学意义（t分别=2．02、2．40、3，59、1，82、1．91、1．96，P均〈0．05）；CD8＋升高，差异均无统计学意义（t分别=1．35、1．45，P均〉0．05）；TSAb、TGAb、TMAb升高，差异均有统计学意义（χ^2分别=9．57、8．35、8．25、9，21、7．79、8．01，P均〈0．05）。妊娠合并初诊Graves病组与初诊Graves病组比较，CD3＋、CD4＋、CD4＋／CD8＋较高，差异均有统计学意义（t分别=1．83、2．02、2．95，P均〈0．05）；CD8＋较低，差异无统计学意义（t=0．73，P〉0．05）；TSAb、TGAb、TMAb较低，差异均有统计学意义（χ^2分别=6．59、5．24、4．87，P均〈0.05）。结论 妊娠合并Graves病人的T淋巴细胞亚群紊乱不如非妊娠状态明显，甲状腺抗体阳性率也较低．与妊娠期机体处于一种免疫抑制状态有关。

Study on the T lymph cell subgroup and thyroid - related antibody in the Graves disease patients with pregnancy

Objective To investigate the immunologic disorder in the Graves disease patients with pregnancy. Methods T lymph cell subgroups CD3 ＋ , CD4 ＋ , CD8 ＋ , and CD4 ＋/CD8 ＋ were detected by flow cytometry with multicolor fluorescence technology in 32 cases of untreated Graves disease patients （group A）, 31 cases of untreated Graves disease patients with pregnancy（group B）, and 28 cases of healthy volunteers（group C） . Thyroid -related antibody （TSAb, TGAb, TMAb） were detected with radioimmunology technology in those patients. Results T lymph cell subgroups（CD3 ＋ , CD4＋ , CD8＋ , CD4＋/CD8＋ , %）in those three groups were： 57.82±5.81, 28.45± 3.87, 34.23±3.91, 0. 72 ± 0. 28 in group A , 62.72±6.13, 34.24±4.16, 33.26±3.71, 1.22±0.34ingroupB, and 69.32v6.83, 39.73 ± 6.85, 31.42± 2.85, 1.65 ±0.49 in group C. The positive percent of thyroid - related antibody （TSAb, TGAb, TMAb） were 56%, 67%, 60% in group A, 20%, 38%, 32% in group B, and 0, 6%, 4% in group C. In group A and group B, compared with group C, CD3 ＋ , CD4 ＋ , CD4 ＋/CD8 ＋ were significantly lower（t = 2.02, 2.40, 3.59, 1.82, 1.91, 1.96, P 〈 0.05）, and TSAb, TGAb, TMAb were significantly higher （χ^2= 9.57, 8.35 , 8.25, 9.21, 7.79, 8.01, P〈 0.05） . In group B, compared with group A, CD3 ＋ , CD4＋ , CD4＋/CD8 ＋ were significantly higher（t = 1.83, 2.02, 2.95, P 〈 0.05）, and TSAb, TGAb, TMAb were significantly lower（χ^2 = 6.59 , 5.24 , 4.87 , P 〈 0.05）. Conclusions Disorder of T lymph cell subgroups and increasing of thyroid - related antibody are less obvious in untreated Graves disease patients with pregnancy, which may be related with immune suppression in pregnancy