【摘要】：目的:觀察橋本甲狀腺炎(HT)、Graves病(GD)患者外周血中濾泡輔助性T細(xì)胞(Tfh)、輔助性T細(xì)胞(Th)17、CD4+CD25+調(diào)節(jié)性T細(xì)胞(Treg),探討HT的免疫學(xué)機(jī)制。方法:2013年3月-2014年12月我院門(mén)診及住院收治HT患者50例,GD患者36例;該段時(shí)期于我院進(jìn)行健康體檢的對(duì)照組30例。通過(guò)流式細(xì)胞術(shù)檢測(cè)三組人群外周血中Tfh、Th17、Treg的數(shù)目及Tfh/CD4+T、Th17/CD4+T、Treg/CD4+T細(xì)胞百分率。結(jié)果:(1)Tfh/CD4+T細(xì)胞百分率:HT組(14.31±2.19)%、GD組(12.98±3.61)%;兩組明顯高于健康對(duì)照組(6.35±1.11)%,差異有統(tǒng)計(jì)學(xué)意義(P0.05),HT患者組與GD患者組差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。(2)Th17/CD4+T細(xì)胞百分率:HT組(2.01±0.48)%、GD組(1.90±1.00)%;兩組均高于健康對(duì)照組(0.57±0.23)%,差異有統(tǒng)計(jì)學(xué)意義(P0.05),HT患者組與GD患者組差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。(3)Treg/CD4+T細(xì)胞百分率:HT組(2.90±1.04)%;GD組(2.58±1.51)%;兩組均低于健康對(duì)照組(4.43±0.57)%,差異有統(tǒng)計(jì)學(xué)意義(P0.05),HT患者組與GD患者組差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。(4)HT組Tfh/CD4+T細(xì)胞百分率與TPOAb、TGAb水平呈正相關(guān)(r=0.31,p0.05;r=0.33,p0.05),Th17/CD4+T細(xì)胞百分率與TPOAb水平呈正相關(guān)(r=0.43,p0.05),與TGAb水平無(wú)明顯相關(guān)性(r=0.19,p0.05),Treg/CD4+T細(xì)胞百分率與TPOAb水平有負(fù)相關(guān)趨勢(shì),無(wú)統(tǒng)計(jì)學(xué)意義(r=0.3,p0.05),與TGAb水平無(wú)明顯相關(guān)性(r=0.14,p0.05)。結(jié)論:HT患者組、GD患者組外周血中Tfh細(xì)胞、Th17/CD4+T細(xì)胞百分率明顯高于健康對(duì)照組,且在HT患者組中Tfh/CD4+T細(xì)胞百分率與TPOAb、TGAb水平呈正相關(guān),Th17/CD4+T細(xì)胞百分率與TPOAb水平呈正相關(guān);而HT患者組、GD患者組外周血中Treg/CD4+T細(xì)胞百分率明顯低于健康對(duì)照組,且Treg/CD4+T細(xì)胞百分率與TPOAb有負(fù)相關(guān)趨勢(shì),無(wú)統(tǒng)計(jì)學(xué)意義,Tfh細(xì)胞、Th17細(xì)胞、Treg細(xì)胞三者與對(duì)臨床上診斷HT最為重要的相關(guān)抗體TPOAb、TGAb相關(guān),這也說(shuō)明通過(guò)檢測(cè)Tfh細(xì)胞、Th17細(xì)胞、Treg細(xì)胞可能對(duì)更好的了解HT的發(fā)病機(jī)制有一定意義。
[Abstract]:Objective: to investigate the immunological mechanism of follicular helper T cells (Tfh), (Tfh), helper T cells (Th) 17), CD4 CD25 regulatory T cells (Treg),) in peripheral blood of patients with Hashimoto's thyroiditis (HT), Graves disease (GD). Methods: from March 2013 to December 2014, 50 patients with HT and 36 patients with GD were treated in our hospital. The number of Tfh,Th17,Treg in peripheral blood of the three groups and the percentage of Th17 / Treg-CD4 / Treg-T T lymphocytes in Tfh/CD4 Th _ 4 / T ~ + T _ 4 were measured by flow cytometry. Results: (1) the percentage of Tfh/CD4 T cells was (14.31 鹵2.19)% in HT group and (12.98 鹵3.61)% in GD group. The difference between the two groups was statistically significant (P0.05), which was significantly higher than that in the healthy control group (6.35 鹵1.11)%. There was no significant difference between HT group and GD group (P0.05). (2) percentage of Th17/CD4 T cells: HT group (2.01 鹵0.48)%, GD group (1.90 鹵1.00)%; Both groups were significantly higher than the healthy control group (0.57 鹵0.23)%, the difference was statistically significant (P0.05). There was no significant difference between HT group and GD group (P0.05). (3) percentage of Treg/CD4 T cells: HT group (2.90 鹵1.04)%; In GD group (2.58 鹵1.51)%; Both groups were lower than the healthy control group (4.43 鹵0.57)%, the difference was statistically significant (P0.05 between), HT group and GD group). There was no significant difference between the two groups (P0.05). (4) the percentage of Tfh/CD4 T cells and TPOAb, in HT group. The level of TGAb was positively correlated (r = 0.31, p 0.05); The percentage of Th17/CD4 T cells was positively correlated with the level of TPOAb (r = 0.43, p0.05), but not with the level of TGAb (r = 0.19, p 0.05). The percentage of Treg/CD4 T cells was negatively correlated with the level of TPOAb. There was no statistical significance (r = 0.3p 0.05), but no significant correlation with the level of TGAb (r = 0.14p 0.05). Conclusion: the percentage of Tfh cells and Th17/CD4 T cells in peripheral blood of HT patients and GD patients is significantly higher than that of healthy controls, and the percentage of Tfh/CD4 T cells in HT patients is positively correlated with TPOAb,TGAb level. The percentage of Th17/CD4 T cells was positively correlated with the level of TPOAb. However, the percentage of Treg/CD4 T cells in peripheral blood of HT patients and GD patients was significantly lower than that of healthy controls, and the percentage of Treg/CD4 T cells was negatively correlated with TPOAb. There was no statistical significance between the percentage of Treg/CD4 T cells and TPOAb. The relationship between Treg cells and TPOAb,TGAb, which is the most important antibody for the diagnosis of HT, also indicates that the detection of Tfh cells, Th17 cells and Treg cells may be helpful to better understand the pathogenesis of HT.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R581.4

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