甲状腺相关眼病患者外周血单核细胞亚型比例分布  

Distribution of monocyte subtypes in peripheral blood of patients with thyroid-associated ophthalmopathy

作　　者：徐迦南 叶慧菁[1] 陈荣新[1] 陈果 陈静巧 杨华胜[1] Xu Jianan;Ye Huijing;Chen Rongxin;Chen Guo;Chen Jingqiao;Yang Huasheng(Zhongshan Ophthalmic Center,Sun Yat-Sen University,State Key Laboratory of Ophthalmology,Guangzhou 510060,China)

机构地区：[1]中山大学中山眼科中心,国家眼科重点实验室,广州510060

出　　处：《中华实验眼科杂志》2020年第11期944-950,共7页Chinese Journal Of Experimental Ophthalmology

基　　金：国家自然科学基金项目(81700875、81870689、81670887)。

摘　　要：目的探讨甲状腺相关眼病(TAO)患者外周血中各亚型单核细胞的分布情况。方法采用横断面研究设计,连续收集2017年1月至2019年12月就诊于中山大学中山眼科中心的TAO患者59例,纳入同期中山大学中山眼科中心进行健康体检的健康人30名。记录TAO患者临床特征,分别采用欧洲Graves眼病专家组的标准和临床活动度评分(CAS)法对TAO进行严重性和活动度评估,根据病情制定治疗方案。采集受试者外周静脉血,分离单个核细胞。采用流式细胞术检测各亚型单核细胞比例分布,对比TAO患者与正常受试者间、不同活动度TAO患者间、TAO患者接受曲安奈德眶周注射或大剂量甲基强的松龙冲击治疗(MPT)前后外周血各亚型单核细胞的比例。结果TAO组经典型单核细胞比例为(81.77±5.53)%,明显低于正常对照组的(84.35±5.83)%,TAO组中间型单核细胞比例为(10.17±4.19)%,明显高于正常对照组的(7.69±4.09)%,差异均有统计学意义(均P<0.05);稳定期TAO组经典型单核细胞比例为(82.64±5.03)%,明显高于活动期TAO组的(77.29±5.80)%,稳定期TAO组中间型单核细胞比例为(9.20±3.56)%,明显低于活动期TAO组的(13.79±4.82)%,差异均有统计学意义(均P<0.01);TAO组与正常对照组间,稳定期TAO组与活动期TAO组间非经典型单核细胞比例比较差异均无统计学意义(均P>0.05);TAO患者曲安奈德眶周注射治疗前后外周血各亚型单核细胞比例比较差异均无统计学意义(均P>0.05)。TAO患者经典型单核细胞比例由MPT治疗前的(75.44±4.80)%增高至治疗后的(82.90±4.05)%,中间型单核细胞比例由MPT治疗前的(14.97±2.60)%下降至治疗后的(10.40±3.76)%,差异均有统计学意义(均P<0.05),MPT治疗前后非经典型单核细胞比例比较差异无统计学意义(P>0.05)。结论TAO患者单核细胞亚型由经典型向中间型偏移,并随TAO活动性升高而明显偏移,MPT治疗能显著抑制单核细胞亚型的偏移。Objective To explore the distribution of different subsets of monocyte in peripheral blood of patients with thyroid-associated ophthalmopathy(TAO).Methods A cross-sectional study was performed.Fifty-nine TAO patients and 30 healthy subjects were recruited continuously in Zhongshan Ophthalmic Center from January 2017 to December 2019.Clinical data of subjects were recorded,and the severity and activity of TAO were graded based on the criteria of NOSPECS and CAS.TAO patients were grouped according to clinical activity of TAO,and the patients were treated by triamcinolone acetonide(TA)injection or methylprednisolone pulse therapy(MPT)accordingly.Peripheral blood of the subjects was collected and monocytes were isolated.The proportion of different monocyte subsets was assayed by a flow cytometry.The differences in distribution of monocyte subsets between TAO group and normal control group,stable TAO group and active TAO group,TA injected group and MPT treated group were compared and analyzed.The study protocol was approved by the Ethics Committee of Zhongshan Ophthalmic Center,Sun Yat-Sen University(No.2014MEKY005),and the written informed consent was obtained from each subject before any medical intervention.Results The proportion of classical monocyte(CMo)subset in TAO group was(81.77%±5.53)%,which was significantly lower than(84.35±5.83)%in the normal control group(P=0.034);the proportion of intermediate monocyte(IMo)subset in the TAO group was(10.17±4.19)%,which was significantly higher than(7.69±4.09)%in the normal control group(P=0.006);no significant difference was found in the proportion of non-classical monocyte(NMo)subset between the two groups(P=0.892).The proportion of CMo subset in the active TAO group was(77.29±5.80)%,which was significantly lower than(82.64±5.03)%in the stable TAO group(P<0.01),and the proportion of IMo subset in the active TAO group was(13.79±4.82)%,which was significantly higher than(9.20±3.56)%in the stable TAO group(P<0.01);no significant change was found in the proportion

关 键 词：甲状腺相关眼病 单核细胞 亚型 曲安奈德 眶周注射 甲基强的松龙 冲击疗法 

分 类 号：R581[医药卫生—内分泌] R771.3[医药卫生—内科学]