Graves眼病患者外周血细胞因子表达的研究

目的　研究Graves眼病患者外周血细胞因子表达及与患病的关系。方法　检测 35例Graves眼病患者急性期行米歇尔方案治疗前和治疗后组及 15例Graves眼病慢性缓解期组患者外周血中白细胞介素 2 (interleukin 2 ,IL 2 )、白细胞介素 6 (interleukin 6 ,IL 6 )、可溶性白细胞介素 2受体(solubleinterleukin 2receptor,sIL 2R)、可溶性白细胞介素 6受体 (solubleinterleukin 6receptor ,sIL 6R)及肿瘤坏死因子 (tumornecosisfacters,TNF)的浓度 ,并将急性期米歇尔方案治疗前与治疗后组患者外周血细胞因子的浓度进行对比。结果　急性期患者治疗前组外周血中的IL 2、sIL 2R、IL 6、sIL 6R及TNF平均浓度分别为 (13 86± 2 0 6 )U/ml、(6 4 2 86± 12 3 90 )U/ml、(10 5 11± 15 77)U/ml、(2 4 38 0 6± 2 18 88)pg/ml及 (49 91± 9 0 8)U/ml,除IL 2外 ,均高于对照组 (P <0 0 1) ;治疗后组外周血中的sIL 2R、sIL 6R及TNF平均水平分别下降至 (437 75± 90 5 4 )U/ml、(2 14 2 31± 30 1 0 8)pg/ml及 (37 6 3± 6 12 )U/ml,接近慢性缓解期患者 ,仍高于对照组。治疗后组、缓解组及对照组外周血中的IL 6平均浓度间差异无显著意义 (P >0 0 5 )。外周血中sIL 2R、IL 6及TNF间呈正相关 (P <0 0 5 )。结论　多

A study of cytokine expression in peripheral blood of patients with Graves' ophthalmopathy

OBJECTIVE: To investigate the expression of interleukin-2 (IL-2), IL-6, soluble interleukin-2 receptors (sIL-2R), sIL-6R and tumor necrosis factors (TNF) in the peripheral blood in patients with Graves' ophthalmopathy and determine the relationship between the serum cytokine levels and the development of the disease. METHODS: The level of serum IL-2, IL-6, sIL-2R, sIL-6R and TNF were measured in the following 3 groups: acute phase (35 patients), chronic phase (15 patients) and control (30 patients). Thirty-two of the acute patients were received the same examination after a course of glucocorticoid therapy. RESULTS: The level of sIL-2R, IL-6, sIL-2R, sIL-6R and TNF in acute patients are (13.86 +/- 2.06) U/ml, (642.86 +/- 123.90) U/ml, (105.11 +/- 15.77) U/ml, (2 438.06 +/- 218.88) pg/ml, (49.91 +/- 9.081) U/ml respectively, significantly higher than that of the normal persons (P < 0.01). After a course of glucocorticoid treatment, sIL-2R, sIL-6R, TNF were decreased to (437.75 +/- 90.54) U/ml, (2 142.31 +/- 301.08) pg/ml, (37.63 +/- 6.12) U/ml, close to the chronic patients, but still higher than normal. After treatment, there was no significant difference of IL-6 level among the 3 groups (P > 0.05). There was positive correlation among IL-6, sIL-2R and TNF level (P < 0.05). CONCLUSION: A serial cytokines participate in the occurrence and development of Graves' ophthalmopathy. Most of them are related to the course and therapy of the disease.