促甲状腺素受体抗体及白细胞介素-2、白细胞介素-6在Graves病131I治疗中的变化及临床意义

目的:研究促甲状腺素受体抗体(TRAb)及白细胞介素-2(IL-2)、白细胞介素-6(IL-6)在Graves病~(131)I治疗中的变化并分析其临床意义。方法:选取2015年8月-2016年8月于我院接受~(131)I治疗的Graves病患者112例为研究对象,按照第6个月的甲状腺功能检查结果的不同分为治愈组(n=54),缓解组(n=21)和甲减组(n=37)。分别比较治疗前、治疗3个月、6个月后三组患者的甲状腺功能指标以及TRAb、IL-2、IL-6水平。结果:治疗前三组患者游离T3(FT3)、游离T4(FT4)、促甲状腺激素(TSH)水平比较差异无统计学意义(P0.05),治疗3个月、6个月后三组患者FT3、FT4水平均明显低于治疗前,而TSH水平明显高于治疗前(P0.05)。治疗3个月、6个月后甲减组FT3、FT4水平均明显低于治愈组、缓解组,治愈组又明显低于缓解组,TSH水平明显高于治愈组、缓解组,治愈组又明显高于缓解组(P0.05)。治疗前三组患者TRAb、IL-2、IL-6水平比较差异无统计学意义(P0.05)。治疗3个月后三组患者TRAb水平均明显高于治疗前(P0.05),治疗6个月后治愈组与甲减组患者TRAb水平与治疗前比较无统计学差异(P0.05),但缓解组患者TRAb水平高于甲减组,差异有统计学意义(P0.05)。治疗3个月、6个月后,治愈组与甲减组患者IL-2、IL-6水平均低于治疗前,而缓解组高于甲减组,差异均有统计学意义(P0.05)。结论:TRAb、IL-2、IL-6可作为评估Graves病~(131)I治疗后的指标,通过检测三项指标治疗前后水平变化情况,从而为临床预后评估提供指导作用。

Changes and Clinical Significance of Thyrotropin Receptor Antibody, Interleukin-2 and Interleukin-6 in Treatment of Graves' Disease by 131I

ABSTRACT Objective: To study the changes of thyrotropin receptor antibody (TRAb) and interleukin-2 (IL-2) and interleukin-6 (IL-6) in the treatment of Graves'' disease by ¹³¹I and to analyze its clinical significance. Methods: A total of 112 patients with Graves'' dis- ease, who were treated with ¹³¹I in Loudi Central Hospital of Hunan Province from August 2015 to August 2016, were selected as re- search subjects. According to the results of thyroid function examination at the 6th month, the patients were divided into cure group (n=54), remission group (n=21) and hypothyroidism group (n=37). The thyroid function indexes and the levels of TRAb, IL-2 and IL-6 were compared among the three groups before treatment, 3 months and 6 months after treatment. Results: There was no significant differ- ence in the levels of free T3 (FT3), free T4 (FT4) and thyroid stimulating hormone (TSH) among the three groups before treatment (P>0.05). 3 months and 6 months after treatment, the levels of FT3, FT4 in the three groups were significantly lower than those before treat- ment, and the level of TSH was significantly higher than that before treatment(P<0.05). 3 months and 6 months after treatment, the levels of FT3, FT4 in hypothyroidism group were significantly lower than those in the cure group and the remission group,the cure group was significantly lower than the remission group, the TSH level was significantly higher than that in the cure group and the remission group, and the cure group was significantly higher than the remission group (P<0.05). There was no significant difference in the levels of TRAb, IL-2 and IL-6 among the three groups before treatment (P>0.05). 3 months after treatment,the level of TRAb in the three groups was sig- nificantly higher than that before treatment (P<0.05); 6 months after treatment, there was no significant difference in the level of TRAb between the cure group and the hypothyroidism group (P>0.05), however, the level of TRAb in the remission group was higher than that in the hypothyroidism group, and the difference was statistically significant (P<0.05). 3 months and 6 months after treatment, the levels of IL-2 and IL-6 in the cure group and the hypothyroidism group were lower than those before treatment, while the remission group were higher than the hypothyroidism group, and the differences were statistically significant (P<0.05). Conclusion: TRAb, IL-2 and IL-6 can be used as indicators for evaluating Graves''disease after treatment by ¹³¹I. It is possible to detect the levels of three indicators before and after treatment so as to provide guidance for clinical prognosis evaluation.