国人甲状腺相关眼病患者血清免疫球蛋白4水平的研究  

Serum IgG4 levels in Chinese patients with thyroid-associated ophthalmopathy

作　　者：吴联群[1] 魏锐利[1] 蔡季平[1] 俞丹洋[1] 

机构地区：[1]第二军医大学附属长征医院眼科,上海200003

出　　处：《中国实用眼科杂志》2016年第1期36-40,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的通过检测甲状腺相关眼病（TAO）患者血清IgG4和IgG的水平，探究IgG4与TAO之间的关系。方法前瞻性病例对照研究。分析和比较在第二军医大学附属长征医院眼科2014年9月至2015年7月期间收治的88例TAO患者和37例对照组的血清IgG4和IgG检测结果，研究IgG4和TAO临床指标之间的关联性。结果TAO活动期组的IgG4水平显著高于TAO静止期组（P=0．046）以及对照组（P=0．021）；TAO静止期组和对照组的IgG4水平差异无统计学意义（P=0．963）。TAO活动期组血清IgG4升高（IgG4≥135mg／dL）的比例显著高于静止期组（P=0．003）和对照组（P=0．007）；TAO静止期组和对照组之间差异无统计学意义（P=0．896）。TAO活动期组IgG4／IgG增加（IgG4／IgG8．0％）的比例显著高于静止期组（P=0．023）以及对照组（P=0.017），但TAO静止期组和对照组之间差异无统计学意义（P=0．756）。CAS为血清IgG4水平的独立影响因素（P=0.021）。IgG4与性别、年龄、TAO病程、突眼度、CAS和严重程度之间均无线性相关性（P值分别为0．767、0.469、0．335、0．385、0．281和0．527）。结论部分TAO活动期患者血清IgG4水平、IgG4／IgG显著升高，并与CAS有关，提示TAO发病机制的异质性可能。Objective To analyze the serum levels of IgG4 and IgG in patients with thyroid-as- sociated ophthalmopathy （TAO）, and to investigate the relationship between the serum levels of IgG4 and TAO. Methods A prospective case control study. The records of 88 patients with TAO and 37 control cases were collected from September 2014 to July 2015 retrospectively in the Department of Ophthalmology, Shanghai Changzheng Hospital, Second Military Medical University, and analyzed the relationship between serum levels of IgG4 and clinical data of patients with TAO. Results IgG4 levels were significantly elevated in patients with active TAO compared to inactive TAO （P = 0.046） and controls （P =0.021）. There was no statistically significant difference for IgG4 levels between inactive TAO and controls （P =0.963）. The proportion of patients with elevated IgG4 levels （IgG4≥135 mg/dL） in active TAO group was significantly higher than that of inactive TAO group （P =0.003） and control group （P =0.007）, but no significant difference was found between inactive TAO group and control group （P =0.896）. Active TAO group had significantly higher proportion of patients with increased IgG4/IgG （IgG4/IgG≥8.0% ）, compared to inactive TAO group （P =0.023） and control group （P =0.017）, but there was no statistically significant difference between inactive TAO group and control group （P =0.756）. Clinical activity score （CAS） was an independent factor affecting IgG4 levels in our patient group. There was no significant correlation between sex, age, duration of TAO, Hertel＇s exophthalmometer readings, CAS, severity and IgG4 levels （P =0.767, P = 0.469, P =0.335, P =0.385, P =0.281 and P =0.527, respectively）. Conclusions The elevation of serum IgG4 levels, IgG4/IgG in part of patients with active TAO affect by CAS may suggest the heterogeneity of the pathogenesis of TAO.

关 键 词：甲状腺相关眼病 IGG4 眼眶IgG4相关疾病 

分 类 号：R563.1[医药卫生—呼吸系统]