【摘要】：目的:通過檢測亞急性甲狀腺炎(SAT)患者外周血中調(diào)節(jié)性T細(xì)胞(Treg)的比例及相關(guān)細(xì)胞因子的濃度;檢測SAT患者甲狀腺組織中叉頭蛋白3(Foxp3)的表達(dá)及分布情況,初步探討Treg細(xì)胞在SAT免疫發(fā)病機(jī)制中的作用和可能的機(jī)制。方法:選取46名SAT患者及15名正常對照者,用流式細(xì)胞術(shù)檢測外周血中CD4+CD25+T細(xì)胞、CD4+CD25+CD127-Treg細(xì)胞占CD4+T細(xì)胞的比例;用ELISA法檢測血清中白細(xì)胞介素-10(IL-10)、轉(zhuǎn)化生長因子β1(TGF-β1)及前列腺素E2(PGE2)的濃度;同時(shí)檢測甲狀腺功能、血沉(ESR)及C反應(yīng)蛋白(CRP)等一般生化指標(biāo);將SAT組與正常對照組的上述指標(biāo)進(jìn)行比較,并進(jìn)行各指標(biāo)的相關(guān)性分析。另選取29名SAT患者及20名正常對照者的甲狀腺標(biāo)本,用免疫組織化學(xué)方法檢測甲狀腺組織中Foxp3的表達(dá)情況,并進(jìn)行兩組間的比較。結(jié)果:1.一般情況:與正常對照組比較,SAT組TT3、TT4、FT3、FT4和CRP濃度升高,TSH濃度降低,ESR速度加快,差異均具有統(tǒng)計(jì)學(xué)意義(P0.05);2.外周血Treg細(xì)胞比例:SAT組外周血CD4+CD25+CD127-Treg細(xì)胞比例明顯低于正常對照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),而CD4+CD25+T細(xì)胞比例及CD4+T細(xì)胞比例與正常對照組比較差異無統(tǒng)計(jì)學(xué)意義(P0.05);3.血清中細(xì)胞因子的濃度:SAT組血清TGF-β1濃度明顯高于正常對照組(P0.05),IL-10及PGE2濃度與正常對照組比較差異無統(tǒng)計(jì)學(xué)意義(P0.05);4.甲狀腺組織中Foxp3蛋白的表達(dá):SAT組甲狀腺組織中Foxp3表達(dá)陽性率明顯高于正常對照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);5.相關(guān)性分析:SAT患者TGF-β1濃度與TT3、TT4、TSH、ESR及CRP均無明顯相關(guān)性(P0.05),Treg細(xì)胞比例與TT3、TT4、FT3、FT4、TSH、ESR及CRP均無明顯相關(guān)性(P0.05),ESR與CRP呈正相關(guān)(r=0.654,P0.05)。結(jié)論:1.SAT患者外周血中Treg細(xì)胞比例下降,而局部甲狀腺組織中Foxp3蛋白的表達(dá)量卻增高,Treg細(xì)胞的總體下降和甲狀腺組織的炎癥損傷加劇是導(dǎo)致SAT發(fā)生的原因。局部甲狀腺組織中Treg細(xì)胞浸潤增加可能是機(jī)體保護(hù)性調(diào)節(jié)作用的結(jié)果;2.Treg細(xì)胞的分化及成熟異常與SAT發(fā)病有關(guān),但與SAT的炎癥強(qiáng)度、臨床表現(xiàn)和甲狀腺功能等指標(biāo)相關(guān)性不強(qiáng),因此Treg細(xì)胞的分化及成熟異常與病情的輕重?zé)o關(guān)。
[Abstract]:Objective: to detect the proportion of regulatory T cell (Treg) and the concentration of cytokines in peripheral blood of patients with subacute thyroiditis (SAT). The expression and distribution of fork head protein 3 (Foxp3) in thyroid gland of patients with SAT were detected, and the role and possible mechanism of Treg cells in the pathogenesis of SAT were preliminarily investigated. Methods: 46 patients with SAT and 15 normal controls were selected to detect the percentage of CD4 CD25 T cells in peripheral blood by flow cytometry, and the proportion of CD4 CD25 CD127-Treg cells to CD4 T cells was determined by flow cytometry. The concentrations of interleukin-10 (IL-10), transforming growth factor 尾 1 (TGF- 尾 1) and prostaglandin E 2 (PGE2) in serum were detected by ELISA method. Thyroid function, erythrocyte sedimentation rate (ESR), (ESR) and C-reactive protein (CRP) were detected and compared between SAT group and normal control group. The expression of Foxp3 in thyroid tissue of 29 patients with SAT and 20 normal controls was detected by immunohistochemical method and compared between the two groups. Results: 1. General conditions: compared with the normal control group, SAT group TT3,TT4,FT3,FT4 and CRP concentration increased, TSH concentration decreased, ESR speed up, the differences were statistically significant (P0.05); 2. Proportion of peripheral blood Treg cells: the proportion of peripheral blood CD4 CD25 CD127-Treg cells in SAT group was significantly lower than that in normal control group, the difference was statistically significant (P0.05). The ratio of CD4 CD25 T cells and CD4 T cells was not significantly different from that of normal control group (P0.05). 3. Serum cytokine concentration: serum TGF- 尾 1 concentration in SAT group was significantly higher than that in normal control group (P0.05), IL-10 and PGE2 levels were not significantly different from those in normal control group (P0.05). The expression of Foxp3 protein in thyroid tissue: the positive rate of Foxp3 expression in thyroid tissue of SAT group was significantly higher than that of normal control group (P0.05). Correlation analysis: there was no significant correlation between TGF- 尾 1 concentration and TT3,TT4,TSH,ESR and CRP in SAT patients (P0.05). There was no significant correlation between), Treg cell ratio and TT3,TT4,FT3,FT4,TSH,ESR and CRP (P0.05). There was a positive correlation between ESR and CRP (P 0.05). Conclusion: the proportion of Treg cells in peripheral blood of patients with 1.SAT decreased, but the expression of Foxp3 protein increased in local thyroid tissue. The overall decrease of Treg cells and the exacerbation of inflammation in thyroid tissue were the causes of SAT. The increase of Treg cell infiltration in local thyroid tissue may be the result of protective regulation. The abnormal differentiation and maturation of 2.Treg cells were related to the pathogenesis of SAT, but not to the inflammation intensity, clinical manifestation and thyroid function of SAT. Therefore, the abnormal differentiation and maturation of Treg cells were not related to the severity of the disease.
【學(xué)位授予單位】：蚌埠醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R581.4

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