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1、乔本氏病针吸细胞学免疫表型观察研究健康大视野?医学分册2007年1月第1期HealthHorizon?MedicalScienceFascicule乔本氏病针吸细胞学免疫表型观察研究论着'刘奉春王永才1大洼县第一人民医院(辽宁大洼124200)辽宁省大连医科大学第二临床学院【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
2、技术,测定T3,FT3,T4,FT4,yT3,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,CIM/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,yT3
3、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%一79.9%,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疾病诊断最权威性诊断和鉴别诊断指标.【关键词】乔本氏病乔本氏病甲状腺内细胞免疫表型[中图分类号]R581.4[文献标识码]A[文章编号]1005—0019(2007)01—00
4、03—03Theobsel'~antiresearchofttmhimoto'sdiseasespinalpuncturecytotogyinmamologicalclassification.LiuFengchun,WangYongcai-ThefirstPeople'5HospitalofDawaCounty,LiaoningProvince.Dawa124200,China.【Abstract]ObjectiveTostudvtheimmunotypeskfintrathyroidallymphocytesimm
5、uneactivityandtheirclinicalsignificanceinpatientswithHashimotosdiseaseMe~lsTheimmunotypeskflymphocytesinf'dtratingthyroidsuch矗sCD3,CD4,CD8CIM/CD8CD71CD19NK,CD44CD95/DasBc1--2,weredetecteelbyFlowLytometrySimultaneouslyT3,FT3,T4FT4yT3TSHTGAandMCAlevelwereinflerame
6、asuredbvradioimmunoassav.ResultsThemajorityofintrathyroidallymphocytesofHashimototo'sdiseasewereTlymphocytes,Blymphocyteswereminora1.TheDroportionofCD3+andCD7+Tceilswashighest.CD4+Tcellswashigher.TheywerehigherthanCD8+Tcells.TheCD4/CD8inthethyroidw:qgnotdifferen
7、tthencomterpartsfromtheperipheralblood.ThenumberkfCD19+,CD10+lympho-cyteswaslowerthaninthenormalperpheralbloodandNKcellswaslowerinthethyroid.Amonytheeightradioimmunoassayitems20%～22%0fT3,FT3,T4,FT4andyT3weremereasedonlvabout69%一79%werenotnormal2%一7%,TSHishighabo
8、ut20%.TAGandMCAwerehighabout79.5%79.9%.andnormalwerelowerabout20.1%一20,5%,ConclusionsItishelpfultounderstandthepatho-genesismechanismkfHashimoto'sbvdirectlvobservingi
