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目的：探讨Ｇｒａｖｅｓ病（ＧＤ）患者异常升高的甲状腺激素与免疫异常之间的因果关系，和抗甲抗腺药治疗ＧＤ期间加用甲状腺素（Ｔ４）的作用。方法：将ＧＤ患者外周血单个核细胞（ＰＢＭＣ）在不同浓度的Ｔ４条件下体外培养６ｄ后，检测Ｔ细胞亚群和培养上清中可溶性白细胞介素２受体（ｓＩＬ２Ｒ）及ＩｇＧ的含量。结果：与正常对照组相比培养后的ＧＤ患者ＰＢＭＣ中ＣＤ８＋Ｔ细胞亚群百分率明显减少（Ｐ＜００１）；培养上清中ｓＩＬ２Ｒ及ＩｇＧ水平显著升高（Ｐ＜００１）；Ｔ４体外对上述指标无明显影响。结论：ＧＤ患者同时具有Ｔ、Ｂ细胞异常；Ｔ４体外对ＧＤ患者的Ｔ、Ｂ细胞功能异常无影响，异常升高的甲状腺激素可能为ＧＤ患者免疫异常的结果而不是导致免疫异常的原因。
Objective: To investigate the causal relationship between abnormally elevated thyroid hormones and immune abnormalities in patients with Graves’ disease (GD) and the role of thyroid hormone (T4) during treatment of GD with anti-thyroid drugs. Methods: Peripheral blood mononuclear cells (PBMCs) from patients with GD were cultured in vitro for 6 days under different concentrations of T4. T lymphocyte subsets and soluble interleukin 2 receptor (sIL2R) and IgG content. Results: Compared with the normal control group, the percentage of CD8 + T lymphocyte subsets in PBMCs was significantly decreased (P <001); the levels of sIL2R and IgG in the culture supernatant were significantly increased (P0.01) ; T4 in vitro no significant effect on the above indicators. Conclusion: Patients with GD have both T and B cell abnormalities. T4 has no effect on T and B cell dysfunction in GD patients. The abnormally elevated thyroid hormone may be the result of immune abnormalities in patients with GD rather than the cause of immunological abnormalities.