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1、首都医科大学学位论文中文摘要目的探讨两种促炎性细胞因子(Cytokine,CK)y一干扰素(Interferon-y,IFN-y)和肿瘤坏死因子一a(TumorNecrosisFactor,TNF-a)在视神经炎(OpticNeuritis,ON)免疫学发病机制的作用,研究二者之间的相互关系,变化规律,及与ON病情的关系。方法采用双色荧光抗体染色技术经流式细胞仪,检测了20例ON患者外周血(PeripheralBlood,PB)中CD3+T细胞内TNF-a及IFN-y,并对活动期和缓解期ON患者及甲基强的松龙(methylprednisolone,MP)冲击
2、疗法治疗前和治疗后的ON患者PB中,CD3+T细胞内TNF-a和IFN-y进行了比较。结果①活动期ON,PB中CD3+T细胞内TNF-a及IFN-y较OND组明显增加(P<0.01,P<0.01),较NC组亦明显增加(P<0.01,P<0.05);OTNF-a与IFN-y呈正向直线相关的关系(r=0.608,P<0.01);③TNF-a与病情严重程度有关(P<0.05);④缓解期ON,PB中TNF-a及IFN-y与活动期比较明显减少(P<0.01,P<0.05),与NC组比较TNF-a亦明显减少(P<0.05),IFN-y则无明显变化(P>0.05).OMP
3、冲击疗法治疗后,TNF-a及IFN-y均较治疗前明显降低(P<0.01,P<0.01).结论TNF-a和IFN-y作为二种重要的促炎性细胞因子参与了ON的免疫病理过程;二者作用协同,在促进、促发炎症、上调疾病方面发挥重要作用。TNF-a和IFN-y虽不是ON的特异性诊断指标,但对监测病情动态变化、评估病情严重程度及指导临床免疫治疗均有较高的价值。关键词视神经炎;CD,+T细胞;肿瘤坏死因子一a;7一干扰素;流式细胞仪首都医科大学学位论文ABSTRACTObjectivesToinvestigatethelevelsofpro-inflammatorycyto
4、kines(CK),TumorNecrosisFactor(TNF-a)andinterferon-y(IFN-y),andtheirefectsinthepathogenesisofOpticNeuritis(ON);Tostudytheirinteraction,alterationandtheirrelationtothestatusofON.MethodsBytheflowcytometricanalysis,atwo-colour-immunofluorescentstainingofcellsurfaceantigenandintracellul
5、arcytokines(TNF-aandIFN-y)inCD3+Tlymphocytesof20patientswithON,otherneurologicaldiseases(OND),aswellasnormalcontrols(NC)wereperformed.WealsocomparedthedifferenceofnumberofTNF-astainingTcellsandIFN-ystainingTcellsbetweentheexacerbationandremissionstage,beforeandaftermethylprednisolo
6、ne(MP)therapy.Results①ONpatientsintheexacerbationstagehavemoreTNF-astainingTcellsandIFN-ystainingTcellsinPBthanOND(P<0.01,P<0.01)orNCgroup(P<0.0l,P<0.05)).②Intheexacerbationstage,thenumberofTNF-astainingTcellswascloselyrelatedtothenumberofIFN-ystainingTcells(r=0.608,P<0.01).③Inthee
7、xacerbationstage,thenumberofTNF-astainingTcellsofthesevereONpatientsissignificantlyhigherthanthatofthemildpatients(P<0.05)..ThenumberofTNF-astainingTcellsofONpatientsinremissionstageissignificantlylowerthanthatofONpatientsinexcacerbationstage(P<0.01)andlowerthannormalcontrols(P<0.0
8、5)aswell.⑤AfterMPtherapy,t