甲状腺功能亢进症患者血浆中TNF-α1和IL-2水平的临床分析

The clinical analysis of the TNF-α1 and IL-2 levels in patients with hyperthyroidism

    摘要
  • 摘要:
    目的 探讨Graves病（GD）、Hashimoto病（HD）等不同病因引起的甲状腺功能亢进症（简称甲亢）患者血浆中肿瘤坏死因子α1（TNF-α1）和白细胞介素2（IL-2）水平的变化特点。
    方法 将250例甲亢患者分为3组，其中，GD组109例、HD组80例、其他病因组61例。正常对照组为98名健康正常人。采用放射免疫分析法检测所有患者及健康正常人血浆中TNF-α1和IL-2的水平。
    结果 250例甲亢患者中，GD组和HD组的TNF-α1水平明显高于其他病因组（dTNF-α1 =17.638和19.248，P均＜0.01）和正常对照组（dTNF-α1 =24.460和26.070，P均＜0.01）；IL-2水平则是明显低于其他病因组（dIL-2=2.668和2.975，P均＜0.01）和正常对照组（dIL-2=2.649和2.955，P均＜0.01）。其他病因组和正常对照组间的TNF-α1和IL-2水平差异均无统计学意义（dTNF-α1=0.821，dIL-2=0.194，P均＞0.05）。
    结论 GD、HD等自身免疫性甲状腺疾病的发生和发展伴有血浆TNF-α1、IL-2水平的改变，而高碘摄取、毒性多结节性甲状腺肿和毒性腺瘤等原因所致甲亢患者的血浆TNF-α1、IL-2水平则无特殊变化。血浆中TNF-α1和IL-2水平的检测分析对于GD和HD的鉴别诊断和疗效评价具有重要的临床意义。

     

    Abstract:
    Objective To explore the characters of plasma levels of the tumor necrosis factor-α1(TNF-α1) and interleukin-2(IL-2) in patients with hyperthyroidism due to multiple etiologies such as Graves disease(GD) and Hashimoto disease(HD) etc.
    Methods Two hundred and fifty hyperthyroidism patients were divided into three groups, including GD group(n=109), HD group(n=80) and other causes of hyperthyroidism group(n=61). Ninty-eight healthy individuals served as control group. The TNF-α1 and IL-2 levels in plasma were measured by radioimmunoassay.
    Results The TNF-α1 level in plasma of GD group and HD group were significantly higher than that of other causes of hyperthyroidism group(dTNF-α1 =17.638 and 19.248, both P < 0.01)and normal group(dTNF-α1 =24.460 and 26.070, both P < 0.01). The IL-2 level in plasma of GD group and HD group were significantly lower than that of other causes of hyperthyroidism group(dIL-2=2.668 and 2.975, both P < 0.01)and normal group(dIL-2=2.649 and 2.955, both P < 0.01). There were no significant differences of the TNF-α1 and IL-2 levels in plasma between other causes of hyperthyroidism group and normal group(dTNF-α1=0.821, dIL-2=0.194, both P > 0.05).
    Conclusions Hyperthyroidism due to autoimmune disease such as GD and HD accompanied with changes of TNF-α1 and IL-2 levels in plasma, while hyperthyroidism due to high iodine uptake, toxic multinodular goiter, and toxic adenoma did not accompany with changes of TNF-α1 and IL-2 levels in plasma. The plasma levels of TNF-α1 and IL-2 may play an important role in differential diagnosis and therapeutic effect evaluation in GD and HD.

     

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