【摘要】：目的:分析Graves病初發(fā)患兒外周血T細(xì)胞亞群變化特點(diǎn);探討Graves病初發(fā)患兒外周血T細(xì)胞亞群與甲狀腺功能的相關(guān)性。方法:收集2015年03月至2016年12月山西省兒童醫(yī)院確診的GD初發(fā)患兒30例為實(shí)驗(yàn)組,健康兒童30例為對照組。測定實(shí)驗(yàn)組和對照組血清CD4+、CD8+、CD4+/CD8+T細(xì)胞的表達(dá),同時(shí)測定兩組FT3、FT4、TSH、TRAb、TPOAb,并進(jìn)行組間比較。對GD初發(fā)患兒T細(xì)胞亞群及TRAb、TPOAb與FT3、FT4、TSH的水平進(jìn)行相關(guān)性分析。結(jié)果:1.與正常對照組比較,GD患兒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)顯著增高(t=8.72,t=10.27,t=6.72,t=5.22,P均0.05);TSH(0.015±0.027m IU/L)顯著降低(t=14.93,P0.05)。2.實(shí)驗(yàn)組外周血CD4+T細(xì)胞(39.50±11.17%)、CD4+/CD8+T細(xì)胞(2.25±0.93%)明顯高于對照組(t=3.223,t=3.601,P均0.05)。CD8+T細(xì)胞(19.33±5.74%)明顯降低(t=2.403,P0.05)。3.實(shí)驗(yàn)組外周血清CD4+T細(xì)胞與FT3、FT4、TSH無明顯相關(guān)性(r=0.321,r=0.350,r=0.014,P均0.05)。CD8+T細(xì)胞與FT3、FT4、TSH無明顯相關(guān)性(r=-0.315,r=-0.330,r=-0.156,P均0.05)。CD4+/CD8+與FT3、FT4呈正相關(guān)(r=0.434,r=0.501,P均0.05),與TSH無相關(guān)性(r=0.063,P0.05)。4.TRAb與TPOAb之間無相關(guān)性(r=-0.023,P0.05)。TRAb與FT3、FT4、TSH之間均無相關(guān)性(r=-0.159,r=-0.138,r=-0.160,P均0.05),TPOAb與FT3、FT4、TSH之間均無相關(guān)性(r=0.104,r=-0.067,r=-0.192,P均0.05)。結(jié)論:1.GD的免疫異常表現(xiàn)為CD4+T激活,CD8+T缺陷和CD4+/CD8+比值增高。2.CD4+/CD8+與甲狀腺功能呈正相關(guān)。3.TRAb與TPOb之間,TRAb與FT3、FT4、TSH之間,TPOAb與FT3、FT4、TSH之間均無相關(guān)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 鹵7.44 pmol/L) and FT4 (79.60 鹵34.93pmol/L), TRAb (6.94 鹵2.84 U / L), TPOAb (265.93 鹵274.37IU/ml) were significantly increased in children with GD. (P < 0.05); TSH (0.015 鹵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 鹵11.17%), CD4 / CD8 T cells (2.25 鹵0.93%) were significantly higher than those in control group (t = 3.223t ~ (3.601), CD8 T cells (19.33 鹵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.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R725.8

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