组织相容性抗原CD45RO肿瘤坏死因子在桥本氏甲状腺炎和亚急性甲状腺炎的表达与免疫损伤的关系及临床意义  

The Relationship Between The Expression of HLA-DR,CD45RO,TNF-α and Immune Injury in HT and SAT and Its Clinical Significance

作　　者：王烯冬[1] 迟宝恩[2] 王越先[3] 白志刚[1] 李利宁[1] 夏医君[1] 梁越[1] 

机构地区：[1]内蒙古自治区医院普外科,内蒙古呼和浩特010017 [2]内蒙古医学院附属医院普外科,内蒙古呼和浩特010050 [3]内蒙古医学院病理教研室,内蒙古呼和浩特010059

出　　处：《内蒙古医学杂志》2004年第4期241-245,共5页Inner Mongolia Medical Journal

摘　　要：目的 :探讨活化T淋巴细胞、肿瘤坏死因子 -α(TNF -α)、组织相容性抗原 (HLA—DR)在桥本氏甲状腺炎 (HT)和亚急性甲状腺炎 (SAT)发病过程中的作用 ,为深入对两病的免疫损伤机理、临床治疗的认识提供理论依据。方法 :应用组织化学、免疫组织化学技术 (S -P法 ) ,观察活化T淋巴细胞标志CD4 5RO、TNF -α、HLA—DR的单克隆抗体在 4 3例HT和 4 2例SAT患者甲状腺组织中的表达。结果 :除正常甲状腺外 ,各例标本浸润的单个核细胞 (TG—MNC)均呈现不同程度的单抗阳性染色。在HT和SAT中 :①CD4 5RO、HLA—DR在其TG—MNC阳性率表达上HT高于SAT ,有显著差异 (0 0 1<P <0 0 5 ) ,TNF -α在其TG—MNC阳性率表达上有极显著差异 (P <0 0 1) ;②甲状腺滤泡上皮细胞 (TEC)的DR表达程度HT明显高于SAT ,有显著差异 (0 0 1<P <0 0 5 ) ,HT中TEC的DR的表达程度与MNC、激活T淋巴细胞、TNF -α均呈正相关 (r分别为 0 7372、0 874 4、0 86 33,P均 <0 0 1) ,而与TNF -α的表达无关。本研究TNF -α的表达HT显著高于SAT ,二者比较有显著差异 (P <0 0 5 )。SAT中TEC的DR抗原表达程度与MNC、激活T淋巴细胞呈正相关 (r分别为 0 7332、0 7931、P均 <0 0 1)。结论 :活化T淋巴细胞、TNF -α、HLA—DR在HT和SAT的发病过程中?Objective:To investigate the effects of activated T lymphocytes,tumor necrosis factor-α(TNF-α),histocompacibility antigen(HLA-DR) on the course of Hashimoto's thyroiditis(HT) and Subacute thyroiditis(SAT),to provide theoretic evidences for understanding their immune and injury mechanisms and clinical treatment.Method:The expression of monoclonal antibodies of CD45RO,TNF-α,HLA-DR marked with activated T lymphocyte in thyroid tissues of 43 HT and 42 SAT was determined by histochemical and tissue immunohistochemistry techniques (S-P methods).Results:Except for normal thyroid,the expresson of monocolonal antibody of infiltrated mononuclear cells (MNC) in all samples was positive.①The positive rate of expression of CD45RO and HLA-DR in MNC was higher in HT than that in SAT(0.01<P<0.05).The TNF-α expression showed significant difference(P<0.01).②DR expression of HT was much higher than that of SAT in thyroid epithelial cells (TEC)(0.01<P<0.05).There was positive correlation between DR expression of TEC and MNC,activated T lymphocytes and TNF-α in HT (r=0.7372,0.8744,0.8633 respectively,P<0.01).There was positive correiatlon between DR expression of TEC and MNC,activated T lymphocytes in SAT (r=0.7332,0.7931 respectively,P<0.01).DR expression of TEC was not associated with the TNF-α expression.The TNF-α expression in HT was significantly higher than that in SAT(P<0.05).Conclusion:Activated T lymphocytes,TNF-α and HLA-DR play an important role in courses of HT and SAT,which supports that the genesis of HT and SAT is associated with autoimmunity.The function of TNF-α on the injury of thyroid epithelium in HT is more obvious than in SAT.Abnormal expression of DR antigen in TFC provides a new reference index for autoimmune thyroid diseases.

关 键 词：桥本氏甲状腺炎 亚急性甲状腺炎 活化T淋巴细胞 肿瘤坏死因子-α 组织相容性抗原 免 疫组化 临床 

分 类 号：R581.4[医药卫生—内分泌]