^(131)I联合甲巯咪唑治疗对Graves病46例外周血Tfh、Tfr细胞表达及甲状腺功能的影响  

Effects of iodine 131 combined with methimazole on the expressions of peripheral blood Tfh,Tfr and thyroid function in patients with Graves’ disease

作　　者：梁坤[1] 戴儒奇[1] 蒙锐[1] 黎芬 LIANG Kun;DAI Ruqi;MENG Rui;LI Fen(Department of Nuclear Medicine,Hainan General Hospital,Hainan Affiliated Hospital of Hainan Medical University,Haikou,Hainan 570311,China)

机构地区：[1]海南省人民医院海南医学院附属海南医院核医学科,海南海口570311

出　　处：《安徽医药》2022年第7期1402-1405,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的 探讨^(131)I联合甲巯咪唑治疗对Graves病人外周血滤泡辅助性T细胞(Tfh)、滤泡调节性T细胞(Tfr)细胞表达及甲状腺功能的影响。方法 选择2018年4月至2019年4月海南省人民医院收治的90例Graves病人,依据随机数字表法将其分成两组,对照组44例仅给予甲巯咪唑治疗,研究组46例给予131I联合甲巯咪唑治疗。比较两组外周血Tfh与Tfr细胞表达水平、甲状腺功能、血清免疫球蛋白M(IgM)与免疫球蛋白G(IgG)水平、随访1年临床复发率。结果 治疗后研究组外周血CD4+T细胞中Tfh细胞的比例[(9.46±3.11)%]低于治疗前[(16.74±3.88)%](P<0.05),Tfr细胞的比例[(5.34±1.72)%]高于治疗前[(1.95±0.62)%](P<0.05),且治疗后研究组外周血CD4+T细胞中Tfh细胞的比例[(9.46±3.11)%]低于对照组[(16.11±3.53)%](P<0.05),Tfr细胞的比例高于对照组(P<0.05)。治疗后两组游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)检测结果均低于治疗前(P<0.05),促甲状腺激素(TSH)检测结果均高于治疗前(P<0.05),且治疗后研究组FT3、FT4检测结果均低于对照组(P<0.05),TSH检测结果高于对照组(P<0.05)。治疗后两组血清IgM、IgG水平均低于治疗前(P<0.05),且治疗后研究组血清IgM、IgG水平均低于对照组(P<0.05)。停药后随访1年,研究组复发率19.57%低于对照组52.27%(χ^(2)=10.50,P=0.001)。结论131I联合甲巯咪唑治疗Graves病,能影响外周血Tfh、Tfr细胞表达,改善甲状腺功能与免疫功能,且随访1年临床复发率低。Objective To investigate the effects of iodine 131 combined with methimazole on the expressions of peripheral blood follicular helper T cells(Tfh),follicular regulatory T cells(Tfr) and thyroid function in patients with toxic diffuse goiter(Graves).Methods Ninety patients with Graves’ disease who were admitted to the Department of Endocrinology of Hainan General Hospital Hainan Affiliated Hospital of Hainan Medical University from April 2018 to April 2019 were selected as the subjects of this study.According to the method of random number table,they were assigned into two groups,44 patients in the control group were only treated with methimazole,while 46 patients in the study group were treated with iodine 131 combined with methimazole.The expression levels of Tfh and Tfr cells in peripheral blood,thyroid function,the levels of serum immunoglobulin M(IgM) and immunoglobulin G(IgG),and 1-year follow-up clinical recurrence rate were compared between the two groups.Results After treatment,the proportion of Tfh cells in CD4+T cells in the study group[(9.46±3.11)%] was lower than that before treatment [(16.74±3.88)%](P < 0.05),and the proportion of Tfr cells [(5.34±1.72)%] was higher than that before treatment [(1.95±0.62)%](P < 0.05),at the same time,after treatment,the proportion of Tfh cells in CD4+T cells in the study group [(9.46±3.11)%] was lower than that in the control group [(16.11±3.53)%](P < 0.05),and the proportion of Tfr cells was higher than that in the control group(P < 0.05).After treatment,free triiodothyronine(FT3) and free tetraiodothyronine(FT4) were lower than those before treatment(P < 0.05),and thyroid-stimulating hormone(TSH) was higher than that before treatment(P < 0.05),at the same time,after treatment,the FT3 and FT4 in the study group were lower than those in the control group(P < 0.05),and the TSH was higher than that in the control group(P < 0.05).After treatment,the levels of serum IgM and IgG in the two groups were lower than those before treatment(P < 0.05),and the levels of s

关 键 词：格雷夫斯病 碘^(131) 甲巯咪唑 滤泡辅助性T细胞 滤泡调节性T细胞 甲状腺功能 

分 类 号：R581.1[医药卫生—内分泌]