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目的:通过观察穿山龙治疗桥本甲状腺炎(HT)患者前后血清自身免疫性抗体:甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)及T淋巴细胞亚群的变化关系,探讨穿山龙治疗HT免疫学作用机制。方法:将48例HT患者随机分为治疗组和对照组,每组24例,对照组给予左旋甲状腺素片治疗调节甲状腺功能至正常并维持治疗,治疗组在此基础上联合应用穿山龙颗粒,早晚各1次,沸水冲服,连续治疗6个月。入组后先测定基线时的三碘甲状腺原氨酸(T3)、四碘甲状腺原氨酸(T4)、游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)、促甲状腺激素(TSH)、TPOAb、TGAb、甲状腺B超(或合甲状腺细针穿刺)、T淋巴细胞亚群;随访6个月后再次测定上述指标。结果:治疗后,治疗组TGAb以及TPOAb水平低于对照组(P<0.05);治疗组CD4+T细胞亚群数值和CD4/CD8比值明显高于对照组(P<0.05)。结论:穿山龙能降低HT患者TPOAb和TGAb的滴度,其机制可能与T淋巴细胞亚群相关。穿山龙能提高CD4+T细胞亚群数值和CD4/CD8比值,改善Th1/Th2失衡状态,从而达到免疫调节功能,改善HT的免疫炎性反应。
OBJECTIVE: To observe the changes of serum autoimmune antibodies: thyroid peroxidase (TPOAb), thyroglobulin antibody (TGAb) and T lymphocyte subsets in patients with Hashimoto’s thyroiditis (HT) before and after treatment. Treatment of HT immunological mechanism. Methods: 48 cases of HT patients were randomly divided into treatment group and control group, 24 cases in each group. The control group was given levothyroxine tablets to regulate thyroid function and maintain the treatment. 1 times, boiling water, continuous treatment for 6 months. After enrollment, triiodothyronine (T3), tetrathionine (T4), free triiodothyronine (FT3), free tetraethionine (FT4) Thyroid stimulating hormone (TSH), TPOAb, TGAb, thyroid B ultrasound (or thyroid fine needle aspiration), T lymphocyte subsets; 6 months after follow-up measurement of these indicators again. Results: The levels of TGAb and TPOAb in the treatment group were lower than those in the control group (P <0.05). The CD4 + T cell subsets and CD4 / CD8 ratio in the treatment group were significantly higher than those in the control group (P <0.05). CONCLUSIONS: Aspirin can reduce the titer of TPOAb and TGAb in HT patients, which may be related to T lymphocyte subsets. Attaprosing can increase CD4 + T cell subsets and CD4 / CD8 ratio and improve the imbalance of Th1 / Th2 so as to achieve immunomodulatory function and improve the immune inflammatory reaction of HT.