131 I治疗前后初诊毒性弥漫性甲状腺肿患者血清CXC趋化因子配体10、白细胞介素6水平的变化及意义

摘要

OBJECTIVE:To probe into the clinical significance and level changes of CXCL 10 and IL-6 before and after graves disease 131I treatment.METHODS: 100 patients with graves disease admitted from Feb.2014 to Feb. 2015 were selected to be divided into observation group and control group via the random number table , with 50 cases in each.The observation group were treated with 131 I, while the control group were given tapazole .The level changes of CXCL10 and IL-6 in two groups were observed before and after treatment .RESULTS:Before treatment , there was no statistical significance between two groups in levels of IL-6, CXCL10 and CXCL10/IL-6 ( P >0.05 ).After treatment of 3d, the levels of IL-6, CXCL10 and CXCL10/IL-6 in observation group significantly increased , yet decreased gradually in the following 1, 3 and 6 months, compared with after treatment , the difference was statistically significant ( P0.05 ) , yet the indicators in control group were higher than that in observation control group , the difference was statistically significant ( P 0.05), while compared with control group , the difference was statistically significant (P<0.05).The incidence rate of adverse drug reaction of observation group was significantly lower than that in the control group, the difference was statistically significant (P<0.05).CONCLUSIONS:The effects of 131I in treatment of graves disease is significant , IL-6 and CXCL10 can be used to evaluate the Th 1/Th2 cell equilibrium state after 131I treatment, which can reflect the immune response of thyroid gland .However, it still needs to make a further study on its correlation with the prognosis .%目的：探讨131I治疗前后初诊毒性弥漫性甲状腺肿患者血清CXC趋化因子配体10（CXCL10）、白细胞介素6（IL-6）水平的变化及意义。方法：选取2014年2月—2015年2月100例初诊毒性弥漫性甲状腺肿患者作为研究对象，按随机数字表法分为对照组与观察组，每组各50例。观察组患者给予131 I治疗，对照组给予他巴唑治疗，观察2组患者治疗前后CXCL10、IL-6水平变化情况。结果：治疗前，2组患者IL-6、CXCL10、CXCL10／IL-6水平的差异无统计学意义（ P＞0.05）。治疗3 d后，对照组患者的CXCL10、IL-6、CXCL10／IL-6明显上升，之后1、3、6个月逐渐下降，与治疗前的差异均有统计学意义（P＜0.05），治疗12个月时各指标与治疗前基本一致，差异无统计学意义（P＞0.05），但明显高于观察组12个月时各指标水平，差异有统计学意义（P＜0.05）；治疗3 d后，观察组患者CXCL10、IL-6、CXCL10／IL-6明显上升，之后1、3、6个月逐渐下降，治疗3 d，1、3个月后各指标与治疗前的差异均有统计学意义（P＜0.05），且以上时间段观察组患者IL-6、CXCL10水平均较对照组变化更为显著，差异均有统计学意义（P＜0.05）；治疗6个月时，观察组患者CXCL10、IL-6、CXCL10／IL-6水平与治疗前的差异无统计学意义（P＞0.05），但与对照组同期比较，差异有统计学意义（P＜0.05）。观察组患者不良反应发生率明显低于对照组，差异有统计学意义（P＜0.05）。结论：131I初诊毒性弥漫性甲状腺肿效果较好，IL-6、CXCL10可作为评估指标评估131 I治疗后的细胞平衡状态，反映甲状腺免疫反应剧烈程度，但其与疾病预后关系仍需作进一步研究。