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目的 探讨GD(格雷夫斯病 )患者经13 1I治疗后红细胞免疫粘附功能变化及其远期疗效的相关性。方法 以甲亢症状、体征为临床疗效观察指标 ,用放免法进行患者甲状腺激素 (FT3 、FT4、TSH)水平测定 ,用外周血红细胞—C3b受体一酵母菌花环形成率 (RBC—C3bR—YR)、红细胞—免疫复合物—酵母菌花环形成率 (RBC—IC—YR)为观察指标 ,对GD患者经13 1I治疗后红细胞免疫粘附功能变化及其远期疗效进行研究。结果 13 1I治疗后 3个月组 ,甲亢症状、体征较治疗前组明显减轻 ,1 5a以上组症状、体征消失 ;RBC—C3bR—YR各组均正常 ,但RBC—IC—YR在治疗前升高 ,疗后 3个月时明显降低 ,但仍高于正常组 ,只有疗后 1 5a以上时 ,方恢复正常 ;时间延长至 2a以上时 ,一组花环率呈正相关。结论 13 1I治疗对GD患者红细胞免疫功能具有“单向性”调整作用 ,其紊乱状态可迅速得以纠正恢复正常 ,无逆转迹象 ;对消除甲亢症状、改善甲亢体征则疗效迅速、稳定且持久。因此 ,RBC—C3bR—YR、RBC—IC—YR是判断病情缓解的有效指标 ,尤其是二相之间的相关性、RBC—IC—YR更有助于阐明治疗机制、进行预后判断
Objective To investigate the relationship between erythrocyte immune function and long-term efficacy of GD (Graves’ disease) patients treated with 131I. Methods Thyroid hormone (FT3, FT4, TSH) levels were measured by radioimmunoassay in patients with hyperthyroidism symptoms and signs. The rate of peripheral blood erythrocyte-C3b receptor-yeast rosette formation (RBC-C3bR-YR) (RBC-IC-YR) was used as an index to investigate the functional changes of erythrocyte immune adherence and its long-term effect after 131I treatment in GD patients. Results 13 months after treatment, the symptoms and signs of hyperthyroidism were significantly reduced compared with the pre-treatment group, and the symptoms and signs disappeared after more than 1 year in the RBC-C3bR-YR group, but RBC-ICRR was normal in the pretreatment High, 3 months after treatment significantly reduced, but still higher than the normal group, only after more than 5a after treatment, the parties returned to normal; when the time is extended to 2a above, a group of rosette rate was positively correlated. Conclusion 13I treatment has the function of “unidirectional” regulation of erythrocyte immune function in patients with GD, and its disorder can be quickly corrected and returned to normal without signs of reversal. It has a rapid, stable and long-lasting effect in eliminating the symptoms of hyperthyroidism and improving the signs of hyperthyroidism. Therefore, RBC-C3bR-YR and RBC-IC-YR are effective indicators to judge the remission, especially the correlation between two phases. RBC-IC-YR is more helpful to elucidate the therapeutic mechanism and prognosis