| 梁坤,戴儒奇,蒙锐,等.131I联合甲巯咪唑治疗对 Graves病 46例外周血 Tfh、Tfr细胞表达及甲状腺功能的影响[J].安徽医药,2022,26(7):1402-1405. |
| 131I联合甲巯咪唑治疗对 Graves病 46例外周血 Tfh、Tfr细胞表达及甲状腺功能的影响 |
| Effects of iodine 131 combined with methimazole on the expressions of peripheral blood Tfh, Tfr and thyroid function in patients with Graves' disease |
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| DOI：10.3969/j.issn.1009-6469.2022.07.030 |
| 中文关键词: 格雷夫斯病 碘 131 甲巯咪唑 滤泡辅助性 T细胞 滤泡调节性 T细胞 甲状腺功能 |
| 英文关键词: Graves' disease Iodine131 Methimazole Follicular helper T cells Follicular regulatory T cells Thyroid func-tion |
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| 摘要点击次数: 1996 |
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| 中文摘要: |
| 目的探讨 131I联合甲巯咪唑治疗对 Graves病人外周血滤泡辅助性 T细胞(Tfh)、滤泡调节性 T细胞(Tfr)细胞表达及甲状腺功能的影响。方法选择 2018年 4月至 2019年 4月海南省人民医院收治的 90例 Graves病人，依据随机数字表法将其分成两组，对照组 44例仅给予甲巯咪唑治疗，研究组 46例给予 131I联合甲巯咪唑治疗。比较两组外周血 Tfh与 Tfr细胞表达水平、甲状腺功能、血清免疫球蛋白 M(IgM)与免疫球蛋白 G(IgG)水平、随访 1年临床复发率。结果治疗后研究组外周血 CD4+T细胞中 Tfh细胞的比例［(9.46±3.11)%］低于治疗前［(16.74±3.88)%］(P<0.05)Tfr细胞的比例［(5.34±1.72)%］高于治疗前［(1.95±0.62)%］(P<0.05)，且治疗后研究组外周血 CD4+T细胞中 Tfh细胞的比例［(9.46，±3.11)%］低于对照组［(16.11±3.53)%］(P<0.05)，Tfr细胞的比例高于对照组(P<0.05)。治疗后两组游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)检测结果均低于治疗前(P <0.05)，促甲状腺激素( TSH)检测结果均高于治疗前(P<0.05)且治疗后研究组 FT3、FT4检测结果均低于对照组( P<0.05)TSH检测结果高于对照组(P<0.05)。治疗后两组血清 IgM、IgG水平均，低于治疗前(P<0.05)且治疗后研究组血清 IgM、IgG水平均低，于对照组(P<0.05)。停药后随访 1年，研究组复发率 19.57%低于对照组 52.27%(χ2=10.50，P，=0.001)。结论 131I联合甲巯咪唑治 |
| 英文摘要: |
| Objective To investigate the effects of iodine 131 combined with methimazole on the expressions of peripheral blood fol-licular helper T cells (Tfh), follicular regulatory T cells (Tfr) and thyroid function in patients with toxic diffuse goiter (Graves).Meth. ods Ninety patients with Graves' disease who were admitted to the Department of Endocrinology of Hainan General Hospital HainanAffiliated Hospital of Hainan Medical University from April 2018 to April 2019 were selected as the subjects of this study. Accordingto the method of random number table, they were assigned into two groups, 44 patients in the control group were only treated with me-thimazole, while 46 patients in the study group were treated with iodine 131 combined with methimazole. The expression levels of Tfhand Tfr cells in peripheral blood, thyroid function, the levels of serum immunoglobulin M (IgM) and immunoglobulin G (IgG), and 1-year follow-up clinical recurrence rate were compared between the two groups.Results After treatment, the proportion of Tfh cells in CD4+ T cells in the study group[(9.46±3.11)%] was lower than that before treatment [(16.74±3.88)%](P < 0.05), and the proportion of Tfr cells [(5.34±1.72)%] was higher than that before treatment [(1.95±0.62)%] (P < 0.05), at the same time, after treatment, the propor-tion of Tfh cells in CD4+ T cells in the study group [(9.46±3.11)%] was lower than that in the control group [(16.11±3.53)%] (P < 0.05), and the proportion of Tfr cells was higher than that in the control group (P < 0.05). After treatment, free triiodothyronine (FT3) and free tetraiodothyronine (FT4) were lower than those before treatment (P < 0.05), and thyroid-stimulating hormone (TSH) was higher than that before treatment (P < 0.05), at the same time, after treatment, the FT3 and FT4 in the study group were lower than those in the control group (P < 0.05), and the TSH was higher than that in the control group (P < 0.05). After treatment, the levels of serum IgM and IgG in the two groups were lower than those before treatment (P < 0.05), and the levels of serum IgM and IgG in the study group were lower than those in the control group (P < 0.05). Followed up for 1 year after discontinuation, the recurrence rate of the study group was19.57%, which was lower than 52.27% of the control group, and the difference between the two groups was statistically significant (χ2= 10.500, P = 0.001).Conclusions Iodine 131 combined with methimazole in the treatment of Graves' disease can affect the expres-sions of Tfh and Tfr cells in peripheral blood, improve thyroid function and immune function, and the 1-year follow-up clinical recur-rence rate is low. |
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