Graves病患者治疗前后血清可溶性细胞间黏附分子-1变化的研究  

Study on the Effects of Serum Soluble Intercellular Adhesion Molecule-1 in Patients with Graves Disease Before and After Treatment

作　　者：白庆双[1] 方佩华[1] 李宁[1] 冯凭[1] 张宝泉[1] 孟召伟[1] 王英姿[1] 

机构地区：[1]天津医科大学总医院核医学科,300052

出　　处：《天津医药》2009年第4期270-273,共4页Tianjin Medical Journal

基　　金：天津市科技发展计划项目(项目编号:05YFGDSF02700)

摘　　要：目的:探讨Graves病(GD)患者血清可溶性细胞间黏附分子-1(sICAM-1)水平在治疗前后不同时期的变化及临床意义。方法:应用酶联免疫吸附测定法(ELISA)分别测定GD患者治疗前和抗甲状腺药物(ATD)治疗后3、6、12、18、24和30个月的血清sICAM-1水平,并与正常对照组相比,同时测定血清游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)、超敏促甲状腺素(sTSH)与sICAM-1进行相关分析。结果:116例正常人sICAM-1为(125.27±29.55)μg/L,阳性率3.45%(4/116);初发GD患者295例为(236.68±72.74)μg/L,阳性率为75.59%(223/295),显著高于正常对照组(P<0.01);应用ATD系统治疗后,在3、6、12、18、24和30个月阳性率分别为78.42%(149/190)、63.01%(92/146)、53.91%(62/115)、30%(24/80)、18.52%(10/54)和13.64%(2/22);至30个月时与正常对照组相比较,血清sICAM-1水平及阳性率差异已无统计学意义(均P>0.05);初诊及治疗后各时期GD患者血清sICAM-1与FT3、FT4、sTSH间均无显著相关性(均P>0.05)。结论:血清sICAM-1可反映GD患者的免疫损伤状态,其作为1个免疫指标对GD辅助诊断、疗效观察以及停药时机的确定有一定的临床意义。Objective： To evaluate the alteration and clinical significance of serum soluble intercellular adhesion molecule （sICAM-1） in patients with Graves disease （GD） in different periods. Methods： The levels of sICAM -1 of GD with untreated and treated were measured with two kinds of ELISA before and 3, 6, 12, 18, 24 and 30 months after the treatment of ATD, and were compared with the normal group. The correlation between slCAM-1 and FT3,FT4,sTSH were analyzed. Results： The serum sICAM-1 level in 116 health adults was （125.27±29.55）ug/L, and the positive ratio was 3.45% （4/116）. The serum sICAM-1 level in 295 untreated GD was （236.68±72.74） ug/L, and the positive ratio was 75.59% （223/295）, which was significantly higher than that of normal group （P 〈 0.01）. The positive ratios were 78.42% （149/190）, 63.01% （92/146）, 53.91% （62/ 115）, 30% （24/80）, 18.52% （10/54） and 13.64% （2/22） 3, 6, 12, 18, 24 and 30 months after the treatment respectively. There was no significant difference in level and positive ratio of serum sICAM-1 30 months after the treatment compared with that of normal group （P 〉 0.05）.There was no correlation between sICAM-1 and the thyreoid function （FT3,FT4,sTSH） either in untreated GD or treated GD（P 〉 0.05）. Conclusion： The serum sICAM-1 can reflect immunologic injury of GD. It can be used as an index in diagnosing, evaluating the therapeutic effects and the time to cease treatment in GD.

关 键 词：格雷夫斯病细胞黏附分子 甲状腺素 三碘甲状腺原氨酸促甲状腺素 酶联免疫吸附测定 

分 类 号：R587.2[医药卫生—内分泌] R581.1[医药卫生—内科学]