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目的:探讨血清中可溶性白细胞介素-2受体(sIL-2R)水平与Graves’眼病的临床表现严重程度和治疗效果的关系。方法:用双抗体夹心ELISA法检测甲状腺功能正常Graves’眼病患者41例和正常对照组49例血清sIL-2R。结果:Graves’眼病患者未用糖皮质激素治疗前血清sIL-2R水平明显高于正常对照组(P<0.001);甲亢型Graves’眼病组与眼型Graves’病组其sIL-2R水平无显著性差异;其治疗前血清SIL-2R在糖皮质激素治疗显效的病例高于无明显治疗效果的病例(P<0.001);sIL-2R的水平与按NOSPECS分级的疾病严重程度无相关。12例患者治疗3个月后复查其sIL-2R水平较治疗前明显降低(P<0.001)。结论:Graves’眼病血清sIL-2R升高可能与眼眶局部淋巴细胞活化有关,可作为评价Graves’眼病的疾病活动性和糖皮质激素治疗效果的参考指标。眼科学报1999;15:78—80。
Objective: To investigate the relationship between the serum sIL-2R level and the severity of Graves’ ophthalmopathy and its therapeutic effect. Methods: Serum sIL-2R was detected by double antibody sandwich ELISA in 41 cases with normal thyroid function in Graves’ eye disease and 49 cases in normal control group. Results: Serum sIL-2R level was significantly higher in patients with Graves’ ophthalmopathy without glucocorticoid treatment (P <0.001). Serum sIL-2R levels were not significantly different between patients with Graves’ ophthalmopathy and those with Graves’ ophthalmopathy (P <0.001). The level of sIL-2R was not correlated with the severity of the disease classified by NOSPECS. The serum SIL-2R level before treatment was significantly higher in glucocorticoid-treated patients than in patients without significant therapeutic effect (P <0.001) The sIL-2R levels of 12 patients after 3 months of treatment were significantly lower than those before treatment (P <0.001). CONCLUSIONS: Elevated serum sIL-2R in Graves ’ophthalmopathy may be related to the activation of local orbital lymphocytes and may be used as a reference index for assessing the disease activity of Graves’ ophthalmopathy and the effect of glucocorticoid therapy. Journal of Ophthalmology 1999; 15: 78-80.