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目的观察甲状腺相关性眼病(TAO)患者外周血单个核细胞(PBMC)中CD4~+、CD8~+T细胞百分比及细胞表面程序性死亡蛋白1(PD-1)的表达水平,探索这两者变化在TAO发病机制及疾病诊断中的意义。方法收集21例TAO患者、21例Graves病(GD)无眼病患者及20例健康对照者资料,采用流式细胞术检测所有受试者PBMC中CD4~+、CD8~+T细胞百分比及其表面PD-1的表达率,比较组间差异,分析其与患者病程、甲状腺功能、甲状腺相关抗体及TAO疾病活动性和严重程度之间的关系。结果 (1)TAO患者PBMC中CD4~+、CD8~+T细胞百分比分别为(35.9±14.5)%、(22.2±8.4)%,GD患者分别为(33.1±13.0)%、(18.6±9.2)%,均高于健康对照者[(17.4±7.4)%、(7.7±4.8)%,P<0.01]。(2)TAO及GD患者PBMC中CD4~+T细胞表面PD-1表达率分别为(8.3±6.4)%、(28.0±26.6)%,均低于健康对照者[(52.2±28.6)%,P<0.01,P<0.05],且TAO患者低于GD患者(P<0.05);TAO患者PBMC中CD8~+T细胞表面PD-1表达率低于健康对照者[(12.7±13.4)%vs(38.2±24.2)%,P<0.01]。(3)TAO患者PBMC中CD8~+T细胞百分比与病程呈正相关(r=0.478,P<0.05)。(4)TAO患者活动期组与非活动期组、轻度组与中重度组间CD4~+、CD8~+T细胞百分比及其表面PD-1表达率差异均无统计学意义(P>0.05)。结论 TAO患者PBMC中CD4~+、CD8~+T细胞百分比及细胞表面PD-1表达存在异常,可能参与TAO的自身免疫过程。
Objective To investigate the expression of CD4 ~ +, CD8 ~ + T cells and PD-1 in peripheral blood mononuclear cells (PBMC) from patients with thyroid associated ophthalmopathy (TAO) Changes in the pathogenesis of TAO and the significance of disease diagnosis. Methods The data of 21 patients with TAO, 21 patients without Graves disease (GD) and 20 healthy controls were collected. The percentage of CD4 ~ +, CD8 ~ + T cells in peripheral blood mononuclear cells PD-1 expression rate, the differences between groups were compared to analyze the relationship with the duration of disease, thyroid function, thyroid-related antibodies and TAO disease activity and severity. Results The percentage of CD4 ~ + and CD8 ~ + T cells in peripheral blood mononuclear cells of TAO patients were (35.9 ± 14.5)% and (22.2 ± 8.4)% respectively, and were 33.1 ± 13.0% and 18.6 ± 9.2% %, All higher than those in healthy controls [(17.4 ± 7.4)%, (7.7 ± 4.8)%, P <0.01]. (2) The expression of PD-1 on CD4 ~ + T cells in TAO and GD patients were (8.3 ± 6.4)% and (28.0 ± 26.6)%, respectively, lower than that in healthy controls [(52.2 ± 28.6)%, (P <0.01, P <0.05), and the TAO patients were lower than GD patients (P <0.05). The expression of PD-1 on CD8 ~ + T cells in TAO patients was lower than that in healthy controls [(12.7 ± 13.4)% vs (38.2 ± 24.2)%, P <0.01]. (3) The percentage of CD8 + T cells in PBMC of TAO patients was positively correlated with the course of disease (r = 0.478, P <0.05). (4) There was no significant difference in the percentage of CD4 ~ +, CD8 ~ + T cells and the expression of PD-1 on the surface of TAO patients between active group and non-active group, mild group and moderate-severe group ). Conclusion The percentage of CD4 ~ + and CD8 ~ + T cells in peripheral blood mononuclear cells and the expression of cell surface PD-1 in TAO patients are abnormal, which may be involved in the autoimmune process of TAO.