甲状腺功能失调患者血清IL-6检测的临床意义
作者:吴世木 谢光云
单位:兴义市人民医院检验科 贵州省兴义市 562400
关键词:白细胞介素-6(IL-6);甲亢;甲减
华夏医学000209 摘要 为探讨甲状腺激素对血清IL-6(Interleukin-6,IL-6)代谢的影响,研究甲状腺功能失调患者血清IL-6水平变化及临床意义。采用双抗体夹心ELISA法对52例甲亢、24例甲减和30例健康对照分别测定血清IL-6。结果:甲亢组血清IL-6与对照组比较明显升高(P<0.01),甲减组血清IL-6与对照组比较无明显差异(P>0.05),甲亢组与甲减组比较有显著性差异,并且甲亢患者血清IL-6与血清T3、T4成正相关。甲亢组治疗缓解后血清IL-6与治疗前有显著性差异(P<0.01)。结论提示检测血清IL-6水平变化可作为甲亢患者治疗效果及预后判断的一项指标,并对甲亢复发的预测有一定的临床意义。
, http://www.100md.com
中图分类号 R581;R446.11+2
Clinical Significance of Serum IL-6 Assay in Patients with Thyroid Disfunction
Wu Shimu,Xie Guangyun
(Xing Yi People's Hospital,Xing Yi,Guizhou 562400)
Abstract To investigate the effects of thyroid hormone on metabolism of serum interleukin-6(IL-6) and clinical significance of changes in IL-6 level in patients with thyroid disfunction,serum IL-6 levels of 52 cases of hyperthyroidism ,24 cases of hypothyroidism and 30 normal subjects were detected by double antibody ELISA.The results showed that serum IL-6 levels in the hyperthyroidism group was significantly higher than that in the group of normal control and that in hypothyroidism (P<0.01),but there was no significant difference between hypothyroidism group and normal subjects (P>0.05),and that serum IL-6 levels in hyperthyroidism were positively correlated with serum T3 and T4 levels.There was a significant difference between serum IL-6 levels in hyperthyroidism before and after therapy (P<0.01).The study results indicated that serum IL-6 can be used as a pramater for evaluating the effect of therapy and prognosis of the disease,and is of clinical significance in prognostication of hyperthyroidism reccurence.
, 百拇医药
Key words Interleukin 6(IL-6);hyperthyroidism;hypothyroidism
IL-6是由T细胞、B细胞、单核巨噬细胞、成纤维细胞等分泌的一种细胞因子,其作用靶细胞种类繁多,在细胞因子网络中发挥着多种生物学功能,其分泌异常往往会导致一些免疫异常性疾病的发生。近年来对IL-6的深入研究发现其与甲亢的发生有密切相关。本文通过对52例甲亢治疗前后血清IL-6水平的变化并与健康对照对比分析,评价其IL-6水平及与临床疗效的关系。
1 材料与方法
1 研究对象 临床确诊的52例甲亢患者(男14例,女38例),平均29岁;甲减24例(男8例,女16例),平均32岁。两组病例均排除其它疾病,甲亢患者未行抗甲状腺治疗,甲减患者未行甲状腺替代治疗。对照组为同期30例健康献血员(男12例,女18例),平均28岁。
, 百拇医药
1.2 血清标本 三组均采集空腹血5ml注入无菌试管,置室温自然凝固,经2500rpm离心20min,分装血清,-80℃冻存待检。
1.3 试剂及方法 IL-6的检测采用第四军医大学免疫教研室提供的试剂盒,用双抗体夹心ELISA法,操作按说明。
2 结果
甲状腺功能失调患者血清IL-6在治疗前的水平与正常对照结果比较见表1,甲亢患者治疗前与治疗缓解后血清IL-6的水平见表2。
结果甲亢组血清IL-6明显高于健康对照组(P<0.01),而甲减组血清IL-6与健康对照组间无显著性变化(P>0.05),甲亢患者缓解后与治疗前比较有显著性差异(P<0.01),并与T3、T4呈正相关。
表1 甲状腺功能失调患者血清IL-6的水平与正常对照比较 (±s) 组别
, 百拇医药
例数
IL-6(ρB/ng.L-1)
与对照组
比较P值
甲亢组与甲减
组比较P值
正常对照
30
51.6±19.2
甲亢组
52
198.3±51.8
, 百拇医药
P<0.01
甲减组
24
47.9±21.3
P>0.05
P<0.01
表2 甲亢患者治疗前、治疗缓解后血清IL-6的水平(±s) 组别
例数
IL-6(ρB/ng.L-1)
P值
, 百拇医药
甲亢治疗前
52
198.3±51.8
甲亢治疗缓解后
52
129.8±32.6
P<0.01
血清IL-6的水平与甲亢的复发:随访停药1.5年内甲亢的复发率,甲亢患者经治疗缓解后血清IL-6在正常对照范围内的41例,其中11例在停药1.5年内复发,复发率为26.8%;甲亢患者经治疗缓解后,血清IL-6在正常对照上限以上的11例,其中8例在停药1.5年内复发,复发率72.7%。经统计学处理(P<0.05),有显著性差异。
3 讨论
, 百拇医药
IL-6是一种多向性细胞活素,十年前已被认为是重要的免疫炎性应答媒介物,血清和组织液中IL-6水平升高已在多种炎性病理生理过程中被证实,如风湿性关节炎、获得性免疫缺陷症、败血症、严重的烧伤和一些肿瘤病变如多发性骨髓瘤[1]。此外,IL-6的多功能作用还表现在可促进造血细胞的增生和诱导肝脏合成C-反应蛋白[2],另有文献报道IL-6参与DIC、心肌梗塞的发病过程[3,4]。本文结果显示甲亢患者血清IL-6水平显著高于对照组(P<0.01),经治疗缓解后IL-6水平显著降低,缓解后血清IL-6水平仍高于正常对照上限者,停药后复发率显著高于缓解后血清IL-6正常者。结果提示IL-6参与甲亢的发生、发展。目前,预测甲亢复发的指标尚少,本实验结果提示甲亢患者经治疗缓解后血清IL-6水平对预测甲亢的复发可能有一定的临床意义。
参考文献
1,Gerard cox,Jack Gauldies.Structure and function of interleukin-6.Cytokine,1993,Springer,97~108
, 百拇医药
2,Cem Gabay,Pascale Roux-Lombard,Philippe de Moerloose,et al.Absence of corre lation Between interleukin-6 and C-Reactive Protein Blood Levels in systemic Lupus Erythemafosus compared with Rheumatoid Arthritis.J Rheumatol,1993,20:5
3,胡翊群,焦洁茹,伍志臻,等.DIC病人血浆白介素-6水平的研究.中国实验诊断学,1997,1(1):29~31
4,邵新华,张卫民,张莉,等.急性心肌梗塞患者血清IL-6的检测.上海医学检验杂志,1999,14(1):16
(收稿 1999-08-11), http://www.100md.com
单位:兴义市人民医院检验科 贵州省兴义市 562400
关键词:白细胞介素-6(IL-6);甲亢;甲减
华夏医学000209 摘要 为探讨甲状腺激素对血清IL-6(Interleukin-6,IL-6)代谢的影响,研究甲状腺功能失调患者血清IL-6水平变化及临床意义。采用双抗体夹心ELISA法对52例甲亢、24例甲减和30例健康对照分别测定血清IL-6。结果:甲亢组血清IL-6与对照组比较明显升高(P<0.01),甲减组血清IL-6与对照组比较无明显差异(P>0.05),甲亢组与甲减组比较有显著性差异,并且甲亢患者血清IL-6与血清T3、T4成正相关。甲亢组治疗缓解后血清IL-6与治疗前有显著性差异(P<0.01)。结论提示检测血清IL-6水平变化可作为甲亢患者治疗效果及预后判断的一项指标,并对甲亢复发的预测有一定的临床意义。
, http://www.100md.com
中图分类号 R581;R446.11+2
Clinical Significance of Serum IL-6 Assay in Patients with Thyroid Disfunction
Wu Shimu,Xie Guangyun
(Xing Yi People's Hospital,Xing Yi,Guizhou 562400)
Abstract To investigate the effects of thyroid hormone on metabolism of serum interleukin-6(IL-6) and clinical significance of changes in IL-6 level in patients with thyroid disfunction,serum IL-6 levels of 52 cases of hyperthyroidism ,24 cases of hypothyroidism and 30 normal subjects were detected by double antibody ELISA.The results showed that serum IL-6 levels in the hyperthyroidism group was significantly higher than that in the group of normal control and that in hypothyroidism (P<0.01),but there was no significant difference between hypothyroidism group and normal subjects (P>0.05),and that serum IL-6 levels in hyperthyroidism were positively correlated with serum T3 and T4 levels.There was a significant difference between serum IL-6 levels in hyperthyroidism before and after therapy (P<0.01).The study results indicated that serum IL-6 can be used as a pramater for evaluating the effect of therapy and prognosis of the disease,and is of clinical significance in prognostication of hyperthyroidism reccurence.
, 百拇医药
Key words Interleukin 6(IL-6);hyperthyroidism;hypothyroidism
IL-6是由T细胞、B细胞、单核巨噬细胞、成纤维细胞等分泌的一种细胞因子,其作用靶细胞种类繁多,在细胞因子网络中发挥着多种生物学功能,其分泌异常往往会导致一些免疫异常性疾病的发生。近年来对IL-6的深入研究发现其与甲亢的发生有密切相关。本文通过对52例甲亢治疗前后血清IL-6水平的变化并与健康对照对比分析,评价其IL-6水平及与临床疗效的关系。
1 材料与方法
1 研究对象 临床确诊的52例甲亢患者(男14例,女38例),平均29岁;甲减24例(男8例,女16例),平均32岁。两组病例均排除其它疾病,甲亢患者未行抗甲状腺治疗,甲减患者未行甲状腺替代治疗。对照组为同期30例健康献血员(男12例,女18例),平均28岁。
, 百拇医药
1.2 血清标本 三组均采集空腹血5ml注入无菌试管,置室温自然凝固,经2500rpm离心20min,分装血清,-80℃冻存待检。
1.3 试剂及方法 IL-6的检测采用第四军医大学免疫教研室提供的试剂盒,用双抗体夹心ELISA法,操作按说明。
2 结果
甲状腺功能失调患者血清IL-6在治疗前的水平与正常对照结果比较见表1,甲亢患者治疗前与治疗缓解后血清IL-6的水平见表2。
结果甲亢组血清IL-6明显高于健康对照组(P<0.01),而甲减组血清IL-6与健康对照组间无显著性变化(P>0.05),甲亢患者缓解后与治疗前比较有显著性差异(P<0.01),并与T3、T4呈正相关。
表1 甲状腺功能失调患者血清IL-6的水平与正常对照比较 (±s) 组别
, 百拇医药
例数
IL-6(ρB/ng.L-1)
与对照组
比较P值
甲亢组与甲减
组比较P值
正常对照
30
51.6±19.2
甲亢组
52
198.3±51.8
, 百拇医药
P<0.01
甲减组
24
47.9±21.3
P>0.05
P<0.01
表2 甲亢患者治疗前、治疗缓解后血清IL-6的水平(±s) 组别
例数
IL-6(ρB/ng.L-1)
P值
, 百拇医药
甲亢治疗前
52
198.3±51.8
甲亢治疗缓解后
52
129.8±32.6
P<0.01
血清IL-6的水平与甲亢的复发:随访停药1.5年内甲亢的复发率,甲亢患者经治疗缓解后血清IL-6在正常对照范围内的41例,其中11例在停药1.5年内复发,复发率为26.8%;甲亢患者经治疗缓解后,血清IL-6在正常对照上限以上的11例,其中8例在停药1.5年内复发,复发率72.7%。经统计学处理(P<0.05),有显著性差异。
3 讨论
, 百拇医药
IL-6是一种多向性细胞活素,十年前已被认为是重要的免疫炎性应答媒介物,血清和组织液中IL-6水平升高已在多种炎性病理生理过程中被证实,如风湿性关节炎、获得性免疫缺陷症、败血症、严重的烧伤和一些肿瘤病变如多发性骨髓瘤[1]。此外,IL-6的多功能作用还表现在可促进造血细胞的增生和诱导肝脏合成C-反应蛋白[2],另有文献报道IL-6参与DIC、心肌梗塞的发病过程[3,4]。本文结果显示甲亢患者血清IL-6水平显著高于对照组(P<0.01),经治疗缓解后IL-6水平显著降低,缓解后血清IL-6水平仍高于正常对照上限者,停药后复发率显著高于缓解后血清IL-6正常者。结果提示IL-6参与甲亢的发生、发展。目前,预测甲亢复发的指标尚少,本实验结果提示甲亢患者经治疗缓解后血清IL-6水平对预测甲亢的复发可能有一定的临床意义。
参考文献
1,Gerard cox,Jack Gauldies.Structure and function of interleukin-6.Cytokine,1993,Springer,97~108
, 百拇医药
2,Cem Gabay,Pascale Roux-Lombard,Philippe de Moerloose,et al.Absence of corre lation Between interleukin-6 and C-Reactive Protein Blood Levels in systemic Lupus Erythemafosus compared with Rheumatoid Arthritis.J Rheumatol,1993,20:5
3,胡翊群,焦洁茹,伍志臻,等.DIC病人血浆白介素-6水平的研究.中国实验诊断学,1997,1(1):29~31
4,邵新华,张卫民,张莉,等.急性心肌梗塞患者血清IL-6的检测.上海医学检验杂志,1999,14(1):16
(收稿 1999-08-11), http://www.100md.com