目的：通过比较研究GD患者131 I、甲巯咪唑治疗外周血中Th17细胞、IL－17的变化，探讨Th17细胞在 GD 发病机制中的作用及意义。方法：收集初诊的GD患者31例采用131I治疗，30例采用甲巯咪唑（MMI）治疗，分别在治疗前（T0）及治疗后1个月（T1）、3个月（T3）进行相关指标测定。另选年龄、性别匹配的29例正常人作为正常对照组。应用流式细胞仪技术检测外周血中Th17细胞比例。采用ELISA 法检测各组血清 IL－17水平。结果：2种治疗方案T0组外周血 Th17细胞及IL－17水平明显高于正常对照组（ P＜0．01）。131 I治疗组外周血Th17细胞及IL－17水平在T0、T1、T3组中水平逐渐下降，仍高于正常对照组（P＜0．01），MMI治疗组变化无统计学差异（P＞0．05）。采用双变量相关性分析得出Th17细胞比例与IL－17水平呈正相关（r＝0．758，P＜0．05），且两者与甲状腺相关抗体呈正相关。结论：Th17细胞、IL－17在初发GD中高表达，Th17细胞可能参与了GD的发病过程。另外，放射性131 I可能通过影响Th17细胞及IL－17起到治疗GD的作用。%Objective:To explore the role of Th17 cells in the pathogenesis with Graves′disease (GD),through examining the proportion of peripheral of Th17 cells and the plasma levels of Interleukin-17 ( IL-17 ) before and after 131 I or methimazol ( MMI ) treatment with GD patients.Methods:We studied 31 subjects and 30 subjects with GD after 131 I or MMI treatment as 131 I therapy group and MMI therapy group and examined as before treatment (T0 ),one month (T1)and three months (T3)after the treatment.29 age-and sexmatched healthy subjects were enrolled as the healthy control group.The Th17 lymphocytes cells were investigated by flow cytometry analysis.The levels of serum IL-17 were measured by ELISA.Results:The proportion of peripheral Th17 cells and the levels of IL-17 were significantly increased in the T0 group GD patients compared with the control group( P<0.01).In the 131 I therapy group the levels of Th17 cells,IL-17 in T0,T1,T3 decreased gradually,but still higher than in normal group( P<0.01) .But there was no sig-nificant difference in MMI therapy group (P>0.05).The proportion of peripheral Th17 cells had positive relationship with the level of IL-17( r=0.758,P<0.05 ) .Both of them were associated positively with thyroid autoantibodies.Conclusion: Th17 cells, IL-17 are highly expressed in the GD.Th17 cells may play an important role in the pathogenesis of GD.In addition,radioactive 131 I may also work on GD via Th17 cells and IL-17.
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