儿童Graves病血清T细胞亚群与甲状腺功能的相关性研究

发布时间：2019-01-09 16:17

【摘要】：目的:分析Graves病初发患儿外周血T细胞亚群变化特点;探讨Graves病初发患儿外周血T细胞亚群与甲状腺功能的相关性。方法:收集2015年03月至2016年12月山西省儿童医院确诊的GD初发患儿30例为实验组,健康儿童30例为对照组。测定实验组和对照组血清CD4+、CD8+、CD4+/CD8+T细胞的表达,同时测定两组FT3、FT4、TSH、TRAb、TPOAb,并进行组间比较。对GD初发患儿T细胞亚群及TRAb、TPOAb与FT3、FT4、TSH的水平进行相关性分析。结果:1.与正常对照组比较,GD患儿FT3(17.94±7.44 pmol/L)、FT4(79.60±34.93pmol/L)、TRAb(6.94±2.84 U/L)、TPOAb(265.93±274.37IU/ml)显著增高(t=8.72,t=10.27,t=6.72,t=5.22,P均0.05);TSH(0.015±0.027m IU/L)显著降低(t=14.93,P0.05)。2.实验组外周血CD4+T细胞(39.50±11.17%)、CD4+/CD8+T细胞(2.25±0.93%)明显高于对照组(t=3.223,t=3.601,P均0.05)。CD8+T细胞(19.33±5.74%)明显降低(t=2.403,P0.05)。3.实验组外周血清CD4+T细胞与FT3、FT4、TSH无明显相关性(r=0.321,r=0.350,r=0.014,P均0.05)。CD8+T细胞与FT3、FT4、TSH无明显相关性(r=-0.315,r=-0.330,r=-0.156,P均0.05)。CD4+/CD8+与FT3、FT4呈正相关(r=0.434,r=0.501,P均0.05),与TSH无相关性(r=0.063,P0.05)。4.TRAb与TPOAb之间无相关性(r=-0.023,P0.05)。TRAb与FT3、FT4、TSH之间均无相关性(r=-0.159,r=-0.138,r=-0.160,P均0.05),TPOAb与FT3、FT4、TSH之间均无相关性(r=0.104,r=-0.067,r=-0.192,P均0.05)。结论:1.GD的免疫异常表现为CD4+T激活,CD8+T缺陷和CD4+/CD8+比值增高。2.CD4+/CD8+与甲状腺功能呈正相关。3.TRAb与TPOb之间,TRAb与FT3、FT4、TSH之间,TPOAb与FT3、FT4、TSH之间均无相关性。
[Abstract]:Aim: to analyze the changes of T cell subsets in peripheral blood of children with Graves disease and to explore the correlation between T cell subsets and thyroid function in children with Graves disease. Methods: from March 2015 to December 2016, 30 children with GD diagnosed in Shanxi Children's Hospital were selected as experimental group and 30 healthy children as control group. The expression of CD4, CD8, CD4 / CD8 T cells in serum of the experimental group and the control group were measured, and the FT3,FT4,TSH,TRAb,TPOAb, of the two groups were measured and compared between the two groups at the same time. The correlation between T cell subsets and the levels of TRAb,TPOAb and FT3,FT4,TSH in children with GD was analyzed. Results: 1. Compared with the control group, FT3 (17.94 卤7.44 pmol/L) and FT4 (79.60 卤34.93pmol/L), TRAb (6.94 卤2.84 U / L), TPOAb (265.93 卤274.37IU/ml) were significantly increased in children with GD. (P < 0.05); TSH (0.015 卤0.027m IU/L) was significantly decreased (tr 14.93 IU/L, P0.05). CD4 T cells in peripheral blood of experimental group (39.50 卤11.17%), CD4 / CD8 T cells (2.25 卤0.93%) were significantly higher than those in control group (t = 3.223t ~ (3.601), CD8 T cells (19.33 卤5.74%) were significantly lower than those in control group (t ~ (2.403). P0.05) There was no significant correlation between CD4 T cells and FT3,FT4,TSH in peripheral blood of experimental group (P 0.05), but there was no significant correlation between CD8 T cells and FT3,FT4,TSH. CD4 / CD8 was positively correlated with FT3,FT4 (P 0.05), but not with TSH (P 0.05). There was no correlation between 4.TRAb and TPOAb (r = 0. 023, P < 0. 05), but there was no correlation between 4.TRAb and TSH (r = 0. 023, P < 0. 05), but there was no correlation between 4.TRAb and TPOAb (r = 0. 023, P < 0. 05), but not with TSH (P = 0. 05). P0.05 there was no correlation between). TRAb and FT3,FT4,TSH (r = 0. 159C, r = 0. 138U, P = 0. 05), TPOAb, P = 0. 05) and FT3,FT4,TSH (r = 0. 104C, r = 0. 067 ~ 0. 1922, P = 0. 05). P 0.05). Conclusion: the immunologic abnormalities of 1.GD are CD4 T activation, CD8 T deficiency and increase of CD4 / CD8 ratio. 2.CD4 / CD8 is positively correlated with thyroid function, 3.TRAb and TPOb, TRAb and FT3,FT4,TSH, TPOAb and FT3,FT4,. There was no correlation between TSH.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R725.8

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