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目的探讨Graves病131I治疗前后自身免疫变化规律及预后相关因素。方法采集30例正常对照及70例Graves病患者131I治疗前、后3、6、9、12月空腹血,检测FT3、FT4、sTSH、TRAb、TGAb、TMAb、IL-2、IL-6。观察各指标变化规律及与近期预后(未愈、痊愈、甲减)的关系。结果①除sTSH外,Graves病患者各指标均显著高于对照组(P<0.01)。②131I疗后TRAb呈升高趋势,IL-2、IL-6、TGAb、TMAb均呈降低趋势。③预后与131I疗前TRAb呈负相关(P=0.04);与131I疗后TMAb呈正相关(P=0.02),IL-2呈负相关(P=0.00)。结论TRAb、TGAb、TMAb、IL-2、IL-6均参与Graves病自身免疫反应,但131I治疗近期预后只与疗前TRAb及疗后TMAb、IL-2密切相关。
Objective To investigate the changes of autoimmunity before and after 131I treatment of Graves disease and the related prognostic factors. Methods Fasting blood was collected before and after 131I treatment in 30 normal controls and 70 patients with Graves disease. The levels of FT3, FT4, sTSH, TRAb, TGAb, TMAb, IL-2 and IL-6 were measured. Observe the changes of each index and the relationship with the recent prognosis (healed, cured, hypothyroidism). Results ①In addition to sTSH, Graves disease patients were significantly higher than the control group (P <0.01). ② The TRAb was increased after 131I treatment, and IL-2, IL-6, TGAb and TMAb all showed a decreasing trend. ③ The prognosis was negatively correlated with TRAb before 131I (P = 0.04). There was a positive correlation between TMAb and TMAb (P = 0.02) and IL-2 after 131I treatment (P = 0.00). CONCLUSIONS: TRAb, TGAb, TMAb, IL-2 and IL-6 are all involved in Graves’ autoimmune reaction. However, the recent prognosis of 131I treatment is only closely related to TRAb, TMAb and IL-2 after treatment.