外周血淋巴细胞亚群监测在甲状腺动脉栓塞治疗Graves病中的意义  

Significance of monitoring lymphocyte subsets in peripheral blood in thyroid arterial embolization to treat Graves' disease

作　　者：靳仓正[1] 赵卫[2] 陈秋艳 李春芳[1] 易根发[2] 张应和[1] 

机构地区：[1]南方医科大学附属南海医院放射科,广东佛山528200 [2]昆明医学院第一附属医院医学影像中心介入室,云南昆明650032 [3]南方医科大学附属南海医院理疗科,广东佛山528200

出　　处：《中国介入影像与治疗学》2008年第3期196-199,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨甲状腺动脉栓塞治疗Graves病(GD)对外周血淋巴细胞亚群的影响。方法对41例临床确诊的Graves病进行甲状腺动脉栓塞治疗,术后随访3～54个月,依据患者症状、体征和甲状腺功能等指标观察疗效。分别于术前、术后1个月、3个月、6个月、12个月及36个月测定外周血淋巴细胞亚群,观察GD患者栓塞治疗前后淋巴细胞的动态变化。结果GD外周血CD3+CD8+细胞比率减少,CD4+/CD8+比值增高。CD16+CD56+细胞于术后1、3个月均高于术前,6个月后降低并接近正常水平;术后CD3+CD8+细胞逐渐增高,1年后达到正常水平;CD4+/CD8+比值于治疗6个月后降至正常水平。复发组CD16+CD56+细胞、CD3+CD8+细胞比率、CD4+/CD8+比值与术前比较差异无统计学意义。结论GD患者体内存在免疫功能紊乱,可以检测到外周血淋巴细胞亚群的异常改变。甲状腺动脉栓塞治疗有效者,外周血淋巴细胞亚群的异常得以缓慢纠正,而复发者则无显著改善。说明介入治疗GD可从免疫调节的水平发挥有效的治疗作用,测定外周血淋巴细胞亚群对于判断疗效有一定意义。Objective To investigate the effect of lymphocyte subsets in peripheral blood of thyroid arterial embolization to treat hyperthyroidism caused by Graves＇ disease（GD）.Methods Forty-one patients with Graves＇ disease were treated with transcatheter arterial embolization,and were followed up according to symptoms,signs and thyroid function during the postoperative of 3-54 months.Dynamic change of lymphocyte was observed by regularly detecting the lymphocyte subsets,including CD16^＋CD56^＋,CD19^＋,CD3^＋,CD3^＋CD4^＋ and CD3^＋CD8^＋ in peripheral blood respectively at different period（before thyroid arterial embolization and at 1st month,3rd month,6th month,12st month and 36rd month after operation）.Results The proportion of CD3^＋CD8^＋ decreased and the ratio of CD4^＋/CD8^＋ increased in peripheral blood of the patients with Graves＇ disease.The levels of CD16^＋CD56^＋ both at 1th and 3th month after interventional therapy were higher than prior-operation,and then got close to normal level after 6 months;The proportion of CD3^＋CD8^＋ gradually increased and got to normal after 12 months,and the ratio of CD4^＋/CD8^＋ decreased to normal after 6 months after therapy.There was no remarkable difference both of the proportions of CD16^＋CD56^＋ and CD3^＋CD8^＋,and of the ratio of CD4^＋/CD8^＋ between before and after operation.Conclusion There is disorder of immune function in the patient with Graves＇ disease,and the abnormity of lymphocyte subsets in peripheral blood can be detected.The disorder of lymphocyte of the responders to interventional therapy can rectify slowly,but scarcely of the recidivists.It demonstrates that thyroid arterial embolization to treat Graves＇ disease achieves significant curative effect by adjusting immune function disorders,and there is considerable significance to detect lymphocyte subsets in peripheral blood.

关 键 词：甲状腺功能亢进症 GRAVES病 淋巴细胞亚群 栓塞 介入性 

分 类 号：R581.1[医药卫生—内分泌] R815[医药卫生—内科学]