外周血CD4^(+)T、CD8^(+)T细胞及免疫活化分子CD38、IL-2R表达水平在Graves眼病患者中的临床意义  

Clinical Significance of Expression Levels of CD4^(+)T,CD8^(+)T Cells and Immune Activating Molecules CD38 and IL-2R in Peripheral Blood in Patients with Graves Ophthalmopathy

作　　者：王鹏飞 周珍 孙晓东 周兴建 Wang Pengfei;Zhou Zhen;Sun Xiaodong(Department of Endocrinology,Xiangyang No.1 People′s Hospital,Hubei University of Medicine,Xiangyang,Hubei 441000,China)

机构地区：[1]湖北医药学院附属襄阳市第一人民医院内分泌科,湖北襄阳441000

出　　处：《四川医学》2024年第1期45-50,共6页Sichuan Medical Journal

摘　　要：目的研究Graves眼病(GO)患者外周血CD4^(+)T、CD8^(+)T细胞及免疫活化分子CD38、IL-2R水平的临床意义。方法选取2022年1月至2023年1月我院收治的80例Graves病(GD)患者为GD组,65例GO患者为GO组,根据CAS评分将GO组患者分为活动期组(26例)和非活动期组(39例),另选50例体检中心健康者为对照组。比较各组血清甲状腺功能、甲状腺相关抗体及外周血各细胞因子水平,分析GO患者外周血各细胞因子水平与甲状腺功能、甲状腺相关抗体、CAS评分的相关性,并分析外周血各细胞因子对GO疾病活动性的预测价值。结果GO组FT3、FT4低于GD组,高于对照组,GD组高于对照组(P<0.05);GO组TSH高于GD组,低于对照组,GD组低于对照组(P<0.05);GO组、GD组TGAb、TPOAb、TRAb、CD4^(+)T高于对照组(P<0.05);GO组、GD组CD8^(+)T低于对照组(P<0.05);GO组CD4^(+)/CD8^(+)T、CD4^(+)CD38^(+)T、CD8^(+)CD38^(+)T、IL-2R高于GD组和对照组,GD组高于对照组(P<0.05)。GO患者活动期组CD4^(+)/CD8^(+)T、CD4^(+)CD38^(+)T、CD8^(+)CD38^(+)T、IL-2R高于非活动期组(P<0.05)。CD4^(+)/CD8^(+)T、CD8^(+)CD38^(+)T与CAS评分呈正相关(P<0.05);CD4^(+)CD38^(+)T与TRAb、CAS评分呈正相关(P<0.05);IL-2R与FT4、TRAb、TPOAb、CAS评分呈正相关(P<0.05)。CD4^(+)/CD8^(+)T、CD4^(+)CD38^(+)T、CD8^(+)CD38^(+)T、IL-2R联合检测预测GO患者疾病活动性的AUC值为0.930,高于外周血四者单独检测(AUC=0.736、0.749、0.668、0.699,P<0.05)。结论外周血CD4^(+)/CD8^(+)T、CD4^(+)CD38^(+)T、CD8^(+)CD38^(+)T、IL-2R联合预测GO活动性的临床价值更高。Objective To investigate the clinical significance of CD4^(+)T,CD8^(+)T cells and immune activating molecules CD38 and IL-2R in peripheral blood of patients with Graves ophthalmopath(GO).Methods The 80 patients with Graves disease(GD)admitted to our hospital from January 2022 to January 2023 were selected as the GD group,and the 65 patients with GO as the GO group.The patients in the GO group were divided into the active group(26 cases)and the inactive group(39 cases)according to the CAS scores,and the 50 healthy people admitted to the physical examination center at the same time were selected as the control group.The levels of serum thyroid function,thyroid related antibodies,and peripheral blood cytokines in each group were compared.The correlation between the levels of peripheral blood cytokines and thyroid function,thyroid related antibodies,and CAS scores in GO patients were analyzed,and the predictive value of peripheral blood cytokines of GO disease activity were analyzed.Results The FT3 and FT4 in GO group were lower than the GD group and higher than the control group,while those in the GD group were higher than those in control group(P<0.05);the TSH in the GO group was higher than the GD group,lower than the control group,and that in the GD group was lower than the control group(P<0.05);the TGAb,TPOAb,TRAb and CD4^(+)T in the GO group and the GD group were higher than those in the control group;the CD8^(+)T in the GO and the GD groups were lower than those in the control group(P<0.05);the CD4^(+)/CD8^(+)T,CD4^(+)CD38^(+)T,CD8^(+)CD38^(+)T,IL-2R in the GO group were higher than those in the GD group and control group,while those in the GD group were higher than those in the control group(P<0.05).The CD4^(+)/CD8^(+)T,CD4^(+)CD38^(+)T,CD8^(+)CD38^(+)T,IL-2R of the active phase group were higher than those of the non active phase group(P<0.05).The CD4^(+)/CD8^(+)T,CD8^(+)CD38^(+)T were positively correlated with score of CAS(P<0.05);CD4^(+)CD38^(+)T was positively correlated with TRAb and score of CAS(P<0.05

关 键 词：GRAVES眼病 Graves病 T淋巴细胞亚群 白细胞介素-2受体 疾病活动性 

分 类 号：R581[医药卫生—内分泌]