本文選題：亞硒酸鈉 + GraVes病��； 參考：《重慶醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的：近年來,硒用于Graves病(Graves disease, GD)的治療,且對GD的治療有益。但硒在細(xì)胞水平對GD的免疫功能影響目前尚未見報道。本文通過亞硒酸鈉對研究對象外周血PBMC的干預(yù),探究亞硒酸鈉對GD患者Treg細(xì)胞的影響。方法：30名重慶醫(yī)科大學(xué)附屬第一醫(yī)院內(nèi)分泌科門診尚未進行任何抗甲亢治療的初診GD患者納入研究,18名性別年齡匹配的健康人群作對照,采集其血液標(biāo)本。血清硒水平使用原子熒光光譜法進行檢測；化學(xué)發(fā)光法檢測FT3、FT4、TSH、TPOAb、TgAb、TRAb。分離GD患者和健康對照組外周血PBMC,每名研究對象均分為兩個小組：一組加亞硒酸鈉處理,另一組加10%胎牛血清RPMI-1640培養(yǎng)基做對照。培養(yǎng)72小時后,qRT-PCR檢測Foxp3 mRNA的表達(dá)水平,ELISA檢測IL-35的分泌水平變化。結(jié)果：(1)GD組血清硒水平為49.4+-15.56μg/L,HC組為84.85+18.27μg/L,GD患者的血清硒水平明顯低于HC組,差異有顯著統(tǒng)計學(xué)意義(P0.001)；(2)與HC組相比,GD組FT3、FT4水平明顯增高,TSH水平明顯降低,差異有統(tǒng)計學(xué)意義(P0.001)。甲狀腺相關(guān)抗體TgAb、TPOAb、TRAb均明顯高于HC組,差異有統(tǒng)計學(xué)意義(P0.001)；(3)亞硒酸鈉干預(yù)前,GD組的Foxp3 mRNA表達(dá)水半、血漿中IL-35的分泌水平明顯低于HC組,差異有顯著統(tǒng)計學(xué)意義(P0.001)；(4)亞硒酸鈉干預(yù)后,與自身干預(yù)前相比較,GD組和HC組均得到類似結(jié)果：Foxp3 mRNA表達(dá)水平、血漿中IL-35的分泌水平增加,差異有統(tǒng)計學(xué)意義(P0.O1,P0.001)；結(jié)論：GD患者血清硒水平低于健康人群,低硒可能GD進展；且Treg細(xì)胞轉(zhuǎn)錄因子Foxp3和細(xì)胞因子IL-35水平降低,提示GD患者Treg細(xì)胞功能下降；亞硒酸鈉可使Graves病患者外周血Treg細(xì)胞功能有所恢復(fù),從而改善Graves病患者的免疫紊亂狀態(tài)。
[Abstract]:Objective: in recent years, selenium has been used in the treatment of Graves disease, and it is beneficial to the treatment of GD.However, the effect of selenium on GD immune function at cellular level has not been reported.The effect of sodium selenite on Treg cells in GD patients was investigated by the intervention of sodium selenite on peripheral blood PBMC.Methods Thirty first diagnosed GD patients in the Department of Endocrinology of the first affiliated Hospital of Chongqing Medical University were enrolled in the study and 18 healthy people matched with sex and age were included in the study and their blood samples were collected.The level of selenium in serum was detected by atomic fluorescence spectrometry, and by chemiluminescence method, the TPOAb-TPOAb-TgAb-TgAb-TRAb. was detected by chemiluminescence method.The peripheral blood PBMCs of GD patients and healthy controls were separated into two groups: one group was treated with sodium selenite and the other group was treated with 10% fetal bovine serum RPMI-1640 as control group.After 72 hours of culture, the expression of Foxp3 mRNA was detected by qRT-PCR and the secretory level of IL-35 was detected by Elisa.Results the serum selenium levels in GD group were 49.4 ~ 15.56 渭 g / L ~ (-1) L ~ (-1), 84.85 ~ 18.27 渭 g 路L ~ (-1 / L) were significantly lower than those in HC group. The difference was statistically significant (P < 0.01). Compared with HC group, the level of FT _ (3) T _ (3) FT _ (4) in GD group was significantly higher than that in HC group, and the difference was statistically significant (P 0.001).The level of Foxp3 mRNA expression in GD group was significantly lower than that in HC group before the intervention of sodium selenite, and the level of IL-35 in plasma was significantly lower than that in HC group.Similar results were obtained between GD group and HC group before intervention, and the level of IL-35 secretion in plasma was increased, the difference was statistically significant (P 0.O 1 P 0.001). Conclusion the level of serum selenium in patients with GD is lower than that in healthy people, and the level of low selenium in GD may progress.The levels of Treg transcription factor Foxp3 and cytokine IL-35 decreased, suggesting that the function of Treg cells was decreased in GD patients, and sodium selenite could restore the function of Treg cells in peripheral blood of patients with Graves disease, thereby improving the immune disorder in patients with Graves disease.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R581

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