Graves病131 I治疗中的细胞因子变化

目的：研究放射性碘（^131 I）治疗Graves病过程中的血清细胞因子的变化,并探讨其临床应用价值。方法：采用ELISA法分别测定初诊甲亢患者（初诊组,n=61）以及甲亢患者131I治愈后（治愈组,n=65）的血清细胞因子白细胞介素（IL）-1β、sIL-2R、IL-5、IL-6以及肿瘤坏死因子-α（TNF-α）的水平,并与健康对照组（n=68）比较；分析各种细胞因子水平与甲状腺激素之间的相关性。结果：初诊组及治愈组患者血清IL-1β、sIL-2R、IL-5、IL-6及TNF-α的水平均显著高于健康对照组（ P〈0.05-P〈0.01）；治愈组的血清细胞因子IL-1β、sIL-2R、IL-5、IL-6及TNF-α与初诊组相比显著下降（P〈0.01）,而TNF-α的水平与健康对照组差异无统计学意义（P〉0.05）；IL-1β与FT4,sIL-2R与TRAb,以及TNF-α与TRAb均呈正相关关系（P〈0.01）。结论：细胞因子IL-1β、sIL-2R、IL-5、IL-6以及TNF-α水平与甲状腺的功能密切相关,可作为评判甲亢患者131 I治疗效果的有价值的指标。

The level change of cytokine during the radioactive iodine treatment of Graves disease

Objective：To investigate the level changes of cytokines during the radioactive iodine（ ^131 I） treatment of Graves disease and its clinical significance. Methods：The serum levels of cytokines including interleukin-1β（IL-1β）,solubility interleukin-2R（sIL-2R）, IL-5,IL-6 and tumor necrosis factor-α（TNF-α） in the patients with Graves disease（n=61）,the cured patients treated with 131I（n=65） and health control group （ n =68 ） were measured by ELISA. The relationships between cytokines and thyroid hormone were analyzed. Results：The levels of IL-1β, sIL-2R, IL-5, IL-6 and TNF-α in patients with Graves disease and the cured patients were significantly higher than those in heath control group（P〈0. 05-P〈0. 01）. Compared with the patients with Graves disease,the levels of IL-1β,sIL-2R,IL-5,IL-6 in the cured patients were decreased significantly（P〈0. 01）,and difference of TNF-α level between the cured patients treated with 131I and health control group was not statistically significant（P〉0. 05）. The levels of serum IL-1βand free thyroxine,sIL-2R and serum thyrotropin receptor antibody（TRAb）,and TNF-α and TRAb were positive correlations（P 〈0. 01）. Conclusions：The serum cytokines levels are closely related to the function of thyroid, which can be used as an evaluation index of radioactive iodine treatment effects for patients with hyperthyroidism.