丙基硫氧嘧啶与甲巯咪唑对Graves病患者细胞因子的影响  

Effect of propylthiouracil and methimazole on serum cytokines in patients with Graves＇ disease

作　　者：杜洪泉[1] 刘玉[1] 贾爱华[1] 张光珍[2] 

机构地区：[1]山东省聊城市人民医院内分泌科,252000 [2]山东省聊城市人民医院病理科,252000

出　　处：《中华内分泌代谢杂志》2012年第9期737-740,共4页Chinese Journal of Endocrinology and Metabolism

摘　　要：将64例Graves病（GD）患者分为甲巯咪唑绀（MMI，n=30）和丙基硫氧嘧啶组（PTU,n=34），20名健康志愿者作为×对照组．采集各组患者治疗前、治疗后3、6个月血清，分别用酶标记免疫吸附法检洲血浆h细胞介素（IL）-2、lL-6及促甲状腺素受体抗体（TRAb）的水平。结果显示，2组治疗前一般情况比较差异无统计学意义。2组刚药后6个月IL-2、IL-6水平较治疗前差异均有明冠统计学意义（p〈0．05），随时间延长IL-2逐渐升高，IL-6逐渐降低；用药6个月后MMI组IL-6水平较PTU组明显降低（P〈0．05）。2组治疗前TRAb水平无显著差异，2组治疗后3和6个月TRAb差异均有统计学意义（均P〈0．01），随时间增加逐渐下降。IL-2／IL-6比值在同一组治疗3、6个月后均较治疗前明显升高（P〈0．05）。治疗6个月后MMI组较盯u组更高（P〈0．05）。GD治疗前血清中IL-6水平与FL、FT。呈正相关，IL-2水平与FL、FT。和TRAb呈负相关；治疗3、6个月后，IL-2、IL-6与FT3、FT4无明显相关性；MMI组治疗前后IL-2、IL-6水平均与TRAb相关。这些结果提示，MMI较PTU更具有改善GD患者自身免疫的作用。Sixty-four patients with Graves＇ diseases were divided into methimazole group （ n = 30 ） and propylthiouracil group （n = 34 ）. 20 healthy volunteers were used as the control group. The levels of interleukin （IL） - 2, IL-6, and TSH receptor antibody （TRAb） were determined by ELISA after serum samples were collected before treatment and after treatment for 3 and 6 months. The results showed that the general data of two groups were not significantly different before treatment. IL-2 and IL45 levels at 6 months after treatment were significantly different from the baseline （ P 〈 0. 05 ）, IL-2 being gradually increased while IL-6 decreased with time. The level of IL-6 in methimazole group was lower than that in propyhhiouracil group after treatment for 6 months （ P〈 0.05 ）. There was no significant difference in TRAb levels between two groups before treatment while differences became significant at 3 and 6 months of treatment （all P 〈 0.01 ）, being gradually decreased with time. IL-2/IL-6 ratio became significantly greater at 3 and 6 months of treatment compared with that before treatment in the same treatment group（ P〈0.05 ） and the ratio in methimazole group was higher than that in propylthiouracil group by 6 months of treatment （ P〈0.05 ）. IL-6 level was positively correlated with FT3 and FT4 levels, and IL-2 level was negatively correlated with FT3 , FT4 , and TRAb levels in GD patients before treatment. The correlations of IL-2 and IL-6 with FT3 and FT4 disappeared by 3 and 6 months of treatment. 1L-2 and IL-6 levels were related with TRAb level before and after treatment in methimazole group. These results suggest that the immunosuppressive effect of methimazole is more evident than that of propyhhiouracil in patients with Graves＇ disease.

关 键 词：甲巯咪唑 丙基硫氧嘧啶 格雷夫斯病 细胞因子 

分 类 号：R581.1[医药卫生—内分泌]