Graves病患者血清IL-23,IL-17及Klotho蛋白水平变化及意义  

Changes of Serum IL-23,IL-17 and Klotho Protein Levels in Patients with Graves Disease

作　　者：罗文 罗钢[1] 周玉玲 胡佩宏 张青林 王莎莎 明媚[1] LUO Wen;LUO Gang;ZHOU Yu-ling;HU Pei-hong;ZHANG Qing-lin;WANG Sha-sha;MING Mei(Department of Ophthalmology,Huangshi Central Hospital of Edongt Healthcare/Affiliated Hospital of Hubei Polytechnic University,Hubei Huangshi 435000,China)

机构地区：[1]鄂东医疗集团黄石市中心医院·湖北理工学院附属医院眼科,湖北黄石435000

出　　处：《现代检验医学杂志》2022年第4期178-182,共5页Journal of Modern Laboratory Medicine

基　　金：湖北省自然科学基金(2017CFB785)。

摘　　要：目的探究Graves病(Graves disease,GD)患者血清白细胞介素(interleukin,IL)-23,白细胞介素(interleukin,IL)-17及Klotho蛋白水平变化及其意义。方法选择2017年3月~2018年3月于鄂东医疗集团黄石市中心医院就诊的GD患者50例作为观察组,选择同期于鄂东医疗集团黄石市中心医院进行健康体检的人群50例作为对照组,患者于清晨空腹状态下采集肘静脉血,利用ELISA试剂盒检测患者血清中IL-23,IL-17及Klotho蛋白的含量;免疫电化学发光法检测患者体内促甲状腺激素(thyroid stimulating hormone,TSH)、游离甲状腺素(free thyroxine,FT4)、游离三碘甲状腺原氨酸(free triiodothyronine,FT3)和TSH受体抗体(TSH-receptor antibody,TRAb)的含量;采用受试者工作特征曲线(receiver operator characteristic curve,ROC)分析IL-23,IL-17和Klotho蛋白指标对GD的诊断和鉴别诊断价值以及用Kaplan-Meier生存曲线对患者的预后进行分析。结论观察组患者体内FT4,FT3及TRAb含量明显高于对照组,TSH含量明显低于对照组,差异均有统计学意义(t=134.964,88.390,108.911,-36.201,均P<0.05);观察组患者血清中IL-17(47.83±1.62pmol/L),IL-23(52.98±6.31pg/ml)及Klotho蛋白(8.97±0.12ng/L)含量明显高于对照组(26.83±1.01pmol/L,10.92±2.01 pg/ml,6.13±0.14 ng/L),差异均有统计学意义(t=77.783,44.910,96.507,均P<0.05);GD组患者血清中IL-17,IL-23,Klotho与TSH呈显著负相关(r=-0.417,-0.599,-0.725,均P<0.05),与FT3,FT4和TRAb呈显著正相关(r=0.389~0.979,均P<0.05);IL-23,IL-17和Klotho蛋白的cut-off分别为2.217 pmol/L,0.672 pg/ml和106.23 ng/L时,对GD的鉴别诊断价值最高;Kaplan-Meier生存分析结果显示高IL-23,IL-27和Klotho水平组患者不良预后发生率均高于低IL-23,IL-27和Klotho水平组(Log-Rankχ^(2)=4.156,4.848,5.765,均P<0.05)。结论IL-23,IL-17及Klotho与甲状腺功能指标具有相关性。其在GD的发病机制中起着重要作用,为GD的治疗提供新的治疗靶点,值得临床推广使用。Objective To investigate the changes and significance of serum interleukin(IL)-23,interleukin(IL)-17 and Klotho protein levels in patients with Graves disease(GD).Methods 50 patients in Huangshi Central Hospital of Edong Healthcare from March 2017 to March 2018 were selected as observation group,50 GD people in the Huangshi Central Hospital of Edong Healthcare were selected as control group.Elbow vein blood was collected on an empty stomach in early morning.Serum IL-23,IL-17 and Klotho protein content was detected by ELISA kit,and thyroid stimulating hormone(TSH),free thyroxine(FT4),free triiodothyronine(FT3)and TSH receptor antibody(TRAb)content were detected by immunopheroluminescence method.The diagnostic and differential diagnostic value of IL-23,IL-17 and Klotho indexes to GD were analysed by Working Characteristic Curve(ROC).Kaplan-Meier survival curve was used to analyze the prognosis of patients.Results The FT4,FT3 and TRAb contents in the observation group were significantly higher than those in the control group,and the TSH contents were significantly lower than those in the control group,the differences were statistically significant(χ^(2)=134.964,88.390,108.911,-36.201,all P<0.05).The contents of serum IL-17(47.83±1.62pmol/L),IL-23(52.98±6.31pg/ml)and Klotho protein(8.97±0.12ng/L)in the observation group were significantly higher than those in the control group(26.83±1.01pmol/L,10.92±2.01 pg/ml,6.13±0.14 ng/L),the differences were statistically significant(t=77.783,44.910,96.507,all P<0.05).There was a significant negative correlation between serum IL-17,IL-23,Klotho and TSH in GD groups(r=-0.417,-0.599,-0.725,all P<0.05).FT3,FT4 and TRAb was positively correlated(r=0.389~0.979,all P<0.05).When IL-23,IL-17 and Klotho cut-off were 2.217 pmol/L,0.672 pg/ml and 106.23 ng/L,respectively,and the value of differential diagnosis was highest.The results of Kaplan-Meier survival analysis showed that the incidence of adverse prognosis was higher in high IL-23 level,high IL-27 level and high Klotho level

关 键 词：弥漫性毒性甲状腺肿 白细胞介素-23 白细胞介素-17 KLOTHO蛋白 

分 类 号：R581.1[医药卫生—内分泌] R392.11[医药卫生—内科学]