摘要
目的探讨乔本氏病针吸甲状腺内浸润淋巴细胞免疫表型活性及临床意义。方法利用流式细胞仪检验技术测定甲状腺内浸润淋巴细胞CD3、CD4、CD8、CD4/CD8、CD7、CD19、NK、CD44、CD95/Fas、Bcl-2免疫活性,同时利用放免检验技术,测定T3、FT3、T4、FT4、γT3、TSH、TGA、MCA8项指标。结果表明乔本氏病甲状腺内浸润淋巴细胞大部分为T淋巴细胞,少数为B淋巴细胞,并且CD3+、CD7+T淋巴细胞比值最高,CD4+T淋巴细胞次之,但均明显高于CD8+T淋巴细胞,CD4/CD8比值与正常外周血相似,CD19+B淋巴细胞及NK细胞比正常外周血B淋巴细胞不同程度减低,诱导细胞凋亡基因CD95/Fas表达明显增高,而抑制凋亡基因Bcl-2减低最明显,CD44正常,显示该病良性免疫反应紊乱疾病。8项放免指标T3、FT3、T4、FT4、γT3各项指标仅有20～22%增高,69～79%均呈正常,2～7%减低,TSH增高有20%,TGA、MCA增高有79.5～79.9%,20.1～20.5%在正常范围内。结论乔本氏病甲状腺内浸润淋巴细胞免疫活性及分布和功能异常,更有助于进一步探讨了解乔本氏病发病机制,为自身免疫性甲状腺疾病诊断、预防、治疗及预后观察提供理论依据,并认为小针头甲状腺针吸细胞病理学对乔本氏病诊断及鉴别诊断有重要诊断价值,明显优越其它传统方法,是目前甲状腺疾病诊断最权威性诊断和鉴别诊断指标。
Objective Object To study the immunotypes of intrathyroidal lymphocytes immune activity and their clinical significance in patients with Hashimoto＇s,disease. Methods The immunotypes of lymphocytes infiltrating thyroid such as CD3 ,CD4,CD8,CD4/CD8 ,CD7 ,CD19, NK ,CD44 and CD95/Fas ,Bcl-2,were detected by Flow Lytometry. Simultaneously T3 ,FT3 ,T4,FT4, γT3 ,TSH ,TGA and MCA level were in sera measured by radioimmunoassay. Results The majority of intrathyroidal lymphoeytes of Hashimototo＇s disease were T lymphocytes ,B lymphocytes were minoral.The proportion of CD3^＋ and CD7＋ T cells was highest . CD4^＋ T cells higher than CD8^＋ T cells. The CD4/CD8 in the thyroid was not different then comterparts from the peripheral blood. The number ofCD19^＋,CD10^＋ lymphoeytes was lower than in the normal perpheral blood and NK cells was lower in the thyroid. Amony the eight radioimmunoassay items20 ～ 22% of T3, FT3 ,T4, FT4 and γT3 were mcreased only about 69 ～ 79% were not normal 2 - 7% ,TSH is high about 20% .TGA and MCA were high about 79.5 - 79.9%,and normal were lower about 20.1 ～ 20.5%. Conclusion It is helpful to understand the pathogenesis mechanism of Hashimoto＇s by directly observing immuneactivity, distribution and function of intrathyroidal Lymphocytes of Hashimoto＇s disease in normal ranges, and it can offer theoral basis on diagnosis,prevention and treatment of autoimmunnal thyroiditis. Fine needle aspirates of thyroid is very valuable to diagnose and identify the Hashimotos disease, and precede the other classical methods apparently.
关键词
乔本氏病
乔本氏病甲状腺内
细胞免疫表型
Hashimoto＇s disease in thyroid of Hashimototo＇s disease, immunotype
