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目的观察Graves病不同阶段患者血清中硒水平的变化,探讨其在Graves病复发中的作用。方法收集Graves病患者90例,其中初诊组30例、缓解组30例、复发组30例,健康查体者30例为对照组。应用原子荧光光谱法测定血清硒水平,ELISA法测定血清促甲状激素受体抗体(TRAb)水平,比色法测定血清谷胱甘肽过氧化物酶(GSH-PX)水平,硫代巴比妥酸法测定血清丙二醛(MDA)水平,电化学发光法测定血清游离三碘甲腺原氨酸(FT3)、游离甲状腺激素(FT4)、甲状腺过氧化物酶抗体(TPOAb)及甲状腺球蛋白抗体(TGAb)的水平。结果血清硒水平初诊组(78.26±19.31)μg/L和复发组(78.86±15.44)μg/L均显著低于对照组(103.01±17.63)μg/L(P<0.01),缓解组(95.65±15.78)μg/L与对照组相比无显著差异(P>0.05),复发组与初诊组相比无显著差异(P>0.05),但较缓解组显著降低(P<0.01);相关分析显示,各组血清硒与GSH-PX呈显著正相关性(P<0.05),与FT3、FT4、TGAb、TPOAb及MDA无显著相关性(P>0.05);各组血清硒与TRAb均呈显著负相关性(P<0.05)。结论血清硒可能通过影响GSH-PX活性及TRAb水平参与了Graves病的发生及复发过程。
Objective To observe the changes of selenium levels in patients with Graves’ disease at different stages and to explore its role in the relapse of Graves disease. Methods 90 patients with Graves disease were collected, including 30 newly diagnosed group, 30 remission group, 30 recurrent group and 30 healthy control group. Serum selenium levels were measured by atomic fluorescence spectrometry, serum thyrotropin-receptor antibody (TRAb) levels by ELISA, serum glutathione peroxidase (GSH-PX) levels by thiobarbituric acid Serum malondialdehyde (MDA) levels were determined by acid method. The level of serum free triiodothyronine (FT3), free thyroid hormone (FT4), thyroid peroxidase antibody (TPOAb) and thyroglobulin Antibody (TGAb) levels. Results Serum selenium level in the newly diagnosed group (78.26 ± 19.31) μg / L and relapse group (78.86 ± 15.44) μg / L were significantly lower than those in the control group (103.01 ± 17.63) μg / L 15.78) μg / L compared with the control group (P> 0.05). There was no significant difference between the recurrent group and the newly diagnosed group (P> 0.05), but significantly lower than that of the remission group (P <0.01) , Serum selenium and GSH-PX in each group had a significant positive correlation (P <0.05), but there was no significant correlation with serum FT3, FT4, TGAb, TPOAb and MDA (P> 0.05) Correlation (P <0.05). Conclusion Serum selenium may participate in the occurrence and relapse of Graves’ disease by affecting GSH-PX activity and TRAb level.