自身免疫甲状腺病患儿细胞因子的失衡及其在发病中的作用  

Cytokine Imbalance and Its Function in Morbidity of Autoimmune Thyroid Disease in Children

作　　者：杨玉[1] 谢理铃[1] 柯江伟[1] 杨利[1] 

机构地区：[1]江西省儿童医院内分泌科,南昌330006

出　　处：《实用儿科临床杂志》2007年第20期1552-1553,共2页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨自身免疫甲状腺病(AITD)儿童血清、干扰素(IFN-γ)、肿瘤坏死因子(TNF-α)、IL-4、IL-6水平变化及在AITD发病中的作用。方法采用双抗体夹心ELISA法对30例弥散性毒性甲状腺肿(GD)和20例桥本甲状腺炎(HT)患儿及30例对照组患儿分别检测血清IFN-γ、TNF-α、IL-4、IL-6水平。结果与对照组相比,GD患儿血清IL-4、6水平明显升高,IFN-γ/IL-4、TNF-α/IL-6值均明显下降(Pa<0.05);HT患儿(GD)IFN-γ、TNF-α水平、IFN-γ/IL-4、TNF-α/IL-6均显著升高(Pa<0.05),GD较HT患儿明显升高(P<0.05),IFN-γ水平HT较GD患儿显著升高(P<0.05)。HT组IFN-γ、TNF-α阳性表达明显高于IL-4、6,而GD组IL-4、6明显高于IFN-γ、TNF-α。结论GD患儿以分泌IL-4、6的Th2浸润为主,而HT患儿则以分泌IFN-γ、TNF-α的Th1浸润为主。儿童AITD的发病与Th1/Th2失衡及其分泌的Th1/Th2细胞因子密切相关。Objective To explore the changes of cytokine levels and their roles in morbidity of autoimmune thyroid disease（AITD） in children. Methods The serum concentrations of interleukin - 4 （ IL - 4 ）, interleukin - 6 （ IL - 6 ）, tumor necrosis factor - α （ TNF - α ）, interferon-γ, （IFN -γ,） were determined with enzyme linked immunosorbent assay （ELISA） among 30 patients with Graves＇ disease （GD） and 20 patients with Hashimotos thyroiditis（HT） and 30 children without AITD subjects. Results The serum levels of IL -4 and IL -6 in patients with GD were higher than those of subjects （ Pa 〈 0.05 ） and the ratios of IFN - γ/IL - 4, TNF - α/IL - 6 significantly decreased （ Pa 〈 0.05 ）, while the serum levels of IFN - γ ,TNF - α and the ratios of IFN - γ IL - 4, TNF - α/ IL - 6 in patients with HT were higher than those of control subjects （ Pa 〈 0.05 ）, and serum IL - 4 and IFN - γ, levels in HT patients were higher than those in GD patients （ Pa 〈 0.05 ）. The po-sitive expressions of Th 1 cytokine （ IFN - γ , TNF - α ） were significantly higher than Th2 cytokine （ IL -4 ,6 ） in HT patients, but the results were just opposite in GD patients. Conclusions GD patients excrete mostly IL -4 and IL -6,but HT patients excrete mostly IFN - γand TNF - α. The autoimmune thyroid disease in children is closely relative to the imbalance of Th1/Th2 and its secretion Th1/Th2 cytokine.

关 键 词：甲状腺炎 自身免疫性 细胞因子类 儿童 

分 类 号：R725.8[医药卫生—儿科]