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双语推荐：自身免疫甲状腺病

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甲状腺相关性眼病的发病机制尚不十分明确.研究表明,此病发病过程中眼眶成纤维细胞既是自身免疫靶细胞,又是效应细胞,是其发病的关键因素.眼眶成纤维细胞自身抗体表达、氧化应激反应在甲状腺相关性眼病中起重要作用,通过对此方面的研究,探索对甲状腺相关性眼病有潜力的新的治疗方法.
Pathogenesis of thyroid associated ophthahnopathy (TAO) is still unclear.Studies showed that orbital fibroblasts were not only the target cells but also the effector in the autoimmune response of TAO.The orbital fibroblasts,through their autoantibodies expression and oxidative stress reaction,might play the important role during the occurrence and development of TAO.Based on the relative studies,the new potential pathway of clinical pharmacotherapy for TAO may be explored.

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目的 探讨γ-干扰素(interferon-γ,IFN-γ)对甲状腺细胞内吲哚胺2,3-双加氧酶(IDO)和色氨酰-tRNA合成酶(TTS)表达的影响及其在Graves病中的免疫病理意义.方法 采用实时荧光定量PCR技术,检测经IFN-γ刺激后甲状腺细胞系Nthy-ori3-1和人甲状腺原代细胞内IDO和TTS mRNA表达情况,及甲状腺组织内IDO和TTS mRNA表达.结果 人甲状腺细胞系Nthy-ori3-1和人甲状腺原代细胞均可低表达IDO和TTS,经IFN-γ刺激后IDO和TTS mRNA量显著增加(P＜0.01);Graves病患者甲状腺组织高表达TTS,较对照组有统计学差异(P=0.018 2),IDO mRNA水平与对照组相比无明显统计学差异,但与IFN-y mRNA水平呈显著相关性(R2=0.716,P=0.002).结论 Graves病发病早期,甲状腺细胞可能通过IFN-y上调IDO,TTS的表达,降解局部色氨酸,抑制自身反应性淋巴细胞功能,平衡过度的自身免疫反应.
Objective To investigate the effect of interferon-γ(IFN-γ) on the expression of indoleamine 2,3-dioxygenase(IDO),and tryptophanyl-tRNA-synthetase (TTS) in thyrocytes; and to study the relevant immunopathological significance in Graves'' disease.Methods The expressions of IDO and TTS genes in IFN-γ stimulated Nthy-ori3-1 cell line and human thyrocytes,as well as in human thyroid tissues were determined by realtime quantitative PCR.Results IDO and TTS genes were expressed slightly in both Nthy-ori3-1 cell line and human thyrocytes,and were significantly up-regulated after IFN-γ stimulation(P＜0.01).Compared to healthy controls,TTS mRNA level was higher in thyroid tissues of patients with Graves'' disease (P =0.018 2),while IDO mRNA level showed no difference,but was notably correlated with IFN-γ mRNA level (R2 =0.716,P =0.002).Conclusion In the early stage of Graves'' disease,thyrocytes may decompose local tryptophan by enhancing the expression of IDO and TTS under IFN-γs

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目的：探讨促甲状腺激素受体刺激性抗体（TSAb），促甲状腺激素受体刺激阻断性抗体（TSBAb）在儿童Graves病（GD）、桥本甲状腺炎（HT）诊治过程中的临床价值与意义。方法88例治疗时间小于6个月的自身免疫甲状腺病（AITD）儿童分为GD 55例（GD组）和HT 33例（HT组），选择同期健康儿童38例（正常组）作为对照。分别用人血清TSAb和TSBAb ELISA试剂盒检测3组血清TSAb、TSBAb的水平，比较3组血清TSAb、TSBAb的差异，并分析血清TSAb、TSBAb之间的相关性及其与血清游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、超敏促甲状腺素（TSH）的关系。结果 GD组血清TSAb水平高于HT组和正常组（均P〈0.05）；HT组血清TSBAb水平高于正常组（P〈0.05）；血清TSAb与TSBAb无相关性（P〉0.05），血清TSAb、TSBAb与FT3、FT4、TSH均无相关性（均P〉0.05）。结论 TSAb、TSBAb分别与儿童GD、HT的发病密切相关，在GD和HT的诊断和治疗中有重要的临床价值。
Objective To study clinical value and significance of thyroid receptor stimulating antibody (TSAb) and thyroid stimulating-blocking antibody (TSBAb) on diagnosis and treatment for children with Graves’disease (GD) and Hashimoto’s thyroiditis (HT). Methods Eighty-eight children with autoimmune thyroid disease (AITD) and treatment time less six months were divided into GD group (n=55) and HT group (n=33). Thirty-eight healthy children were used as control (Normal group). Human serum TSAb ELISA kit and human TSBAb ELISA kit were used to detect the serum TSAb and serum TSBAb in three groups. The serum levels of TSAb and TSBAb were compared between three groups. The correla? tion between TSAb and TSBAb, TSAb/TSBAb and free triiodothyronine three (FT3), free thyroxine (FT4), ultra sensitive thy?roid stimulating hormone (TSH) were analyzed. Results The serum level of TSAb was significantly higher in GD group than that of HT group and Normal group (P 0.05). There were no significan

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目的探讨乳腺癌患者自身免疫与非自身免疫甲状腺疾病的发病情况。方法选择100例乳腺癌手术患者，以同期相对应年龄无乳腺疾病及甲状腺疾病病史女性100名为对照组，通过临床检查、B型超声、甲状腺素及抗体水平检查、细针穿刺活组织检查等对比甲状腺疾病的发病情况。结果乳腺癌患者抗甲状腺过氧化物酶抗体明显高于对照组[（104．56±21．54）U／ml比（22．16±4．65）u／ml，P=0．030]。乳腺癌组自身免疫与非自身免疫甲状腺疾病的发病率高于对照组[38％（38／100）比17％（17／100），P=0．0009；26％（26／100）与9％（9／100），P=0．0016]。结论乳腺癌患者的自身免疫与非自身免疫甲状腺疾病的发病率高于非乳腺癌者。
Objective To investigate the incidence of autoimmune and nonautoimmune thyroid diseases in patients with breast cancer.Methods Clinical and ultrasound evaluation of thyroid gland,detection of serum thyroid hormone and related antibodies,and fine-needle aspiration of thyroid gland were performed in 100 breast cancer patients and 100 control individuals during the period from 2004 to 2008.Results The mean values of anti-thyroid peroxidase antibodies were significantly higher in breast cancer patients than that in control individuals [(104.56±21.54) U/ml vs (22.16±4.65) U/ml,(P=0.030)].The incidence rates of autoimmune and nonautoimmune thyroid diseases were higher in breast cancer patients than that in control individuals[38 ％ (38/100) vs 17 ％ (17/100),P=0.0009,26 ％ (26/100) vs 9 ％ (9/100),P =0.0016,respectively].Conclusion The results indicate an increased incidence of autoimmune and nonautoimmune thyroid diseases in breast cancer patients.

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目的 总结僵人综合征(SPS)及变异型患者的临床特点及电生理特点,并对其伴发自身免疫病或肿瘤的概率以及抗谷氨酸脱羧酶(GAD)抗体滴度对临床症状严重程度及预后的预测价值进行分析.方法 收集北京协和医院2001-2012年诊断为SPS的8例患者的临床与辅助检查资料,并进行Rankin评分和统计伴发自身免疫病或肿瘤的概率；应用SPSS 17.0软件对抗GAD抗体滴度与临床症状严重程度、治疗效果的关系进行统计学分析.结果 8例SPS患者中7例主要表现为躯干和下肢强直痉挛.6例行针极肌电图检查,4例可见安静状态下持续的运动单位电位活动,其中以躯干肌最明显.4例行脑电图检查,均无异常癫痫样放电.7例行抗GAD抗体检查,5例呈阳性,其中3例伴发糖尿病,4例伴发甲状腺疾病,1例伴发肿瘤；2例呈阴性,无伴发糖尿病,1例伴发甲状腺疾病,1例伴发肿瘤.血抗GAD抗体滴度＞2.000×106 U/L者治疗前Rankin评分分别为5、4、4分,治疗后分别改善1、2、2分,血抗GAD抗体滴度＜2.000×106 U/L者治疗前评分为4、4分,治疗后分别改善2、2分,两者治疗前Rankin评分差异无统计学意义(U =2.000,P=0.414),治疗后评分改善程度差异无统计学意义(U=2.000,P=0.414).结论 SPS患者临床上主要表现为以躯干为主的肌肉僵硬、痉挛,肌电图上表现为安静状态下主动肌和拮抗肌持续的运动单位电位活动.抗GAD抗体滴度对临床症状严重程度及预后可能不具有预测价值,但根据抗GAD抗体是否阳性对SPS患者进行分类,有助于预测患者合并自身免疫病及肿瘤的风险.
Objective To demonstrate the clinical and electrophysiological characteristics of stiffperson syndrome (SPS) and variants,investigate the frequency of coexisting autoimmune disease and cancer,and determine the correlation between anti-glutamic acid decarboxylase (GAD) antibody titers and severity and outcome of the disease.Methods Clinical and electrophysiological data of 8 SPS patients of Peking Union Medical College Hospital between 2001 and 2012 were collected.We used Rankin Scale to score and count the probability of coexisting autoimmune disease and cancer,and used SPSS 17.0 to analyze the correlation between anti-GAD antibody titers,severity and outcome of the disease.Results Seven out of the 8 SPS patients were rigidity and spasms of trunk and lower extremities.Four out of the 6 patients underwent electromyography examination showed evidence of continuous motor unit activity,especially in paraspinal muscles.None of the 4 patients underwent electroencephalography examination show

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本文探讨了丙型肝炎病毒感染、干扰素治疗与甲状腺疾病的关系,同时对与此相关的甲状腺疾病的类型和转归进行综述.丙肝病毒感染和干扰素治疗会增加甲状腺疾病的发生,易感人群为女性、甲状腺自身抗体阳性的患者.常见的甲状腺疾病为非自身免疫和自身免疫性甲状腺炎,弥慢性毒性甲状腺肿较少见.甲状腺功能状态常表现为一过性甲状腺功能亢进和甲状腺功能减退.非自身免疫性甲状腺炎患者甲状腺功能易恢复.
The article explores the relationship of the hepatitis C virus infection with interferon treatment and thyroid diseases and reviews the subtypes of the thyroid diseases.Autoimmune and nonautoimmune cases of thyroiditis are often seen in patients with chronic hepatitis C while undergoing interferon treatment,especially in females with positive thyroid autoantibodies.Graves'' disease is very rare.The thyroid function may be as a transient thyrotoxicosis,then followed by hypothyroidism.The thyroid function in patients with nonautoimmune thyroiditis is usually easy to recover.

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甲状腺相关性眼病是发生在眶内与甲状腺自身免疫紊乱相关的炎症性眼病.传统的治疗方法效果有限且不良反应较大.近年来人们开发了新型免疫抑制剂,可治疗甲状腺相关性眼病,使患者的症状得到明显改善,临床活动评分显著降低.
Thyroid-associated ophthalmopathy (TAO) is an inflammatory eye disease associated with thyroid autoimmune disorder.The traditional treatments have yielded limited efficacy but with some side effects.Recently,researches have shown that some new immunosupressants may be used for the treatment of TAO with significantly improved symptoms,and reduction in clinical activity score.

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目的：对成人隐匿性自身免疫糖尿病（LADA）与甲状腺自身免疫之间的关系进行探讨。方法选取在我院就诊的300例糖尿病患者，其中包括94例LADA患者，100例1型糖尿病(T1DM）患者，106例2型糖尿病（T2DM）患者，并与100例健康人群相对照，对健康人群与患病人群均进行甲状腺球蛋白抗体（TG￣Ab）及甲状腺过氧化物酶抗体检测（TPO￣Ab）检测，糖尿病患者还需进行谷氨酸脱羧酶检测（GAD￣Ab），比较检查结果的差异性。结果(1)LADA组的阳性检出率均较正常对照组高(P＜0.05)，同时与T2DM组相比,LADA组与T1DM组的TPO-Ab检出率更高(P＜0.05),而LADA组与T1DM组的检出率之间无显著性差异(P＞0.05)。(2)对于LADA患者，甲状腺抗体检测阳性的患者其甲状腺功能异常发生率高于抗体检测阴性者，两组之间无显著性差异(P＞0.05)。结论通过甲状腺抗体检测，发现LADA患者的甲状腺功能异常的发生风险较大，其十分容易合并自身的甲状腺免疫紊乱。
Objective To discusses the relationship between adult-onset latent autoimmune dia-betes (LADA)and thyroid autoimmunity. Methods 300 cases of diabetic patients including 94 cases of LADA patients, 100 T1DM patients, 106 T2DM patients, were compared with 100 cases of healthy people. They are detected thyroglobulin antibody (TG￣Ab) and thyroid peroxidase anti-body detection (TPO￣Ab), at the same time patients with diabetes accepted glutamic acid decar-boxylase (GAD￣Ab) detection, compared the differences of test. Results (1)The positive detection rate of LADA group was higher than normal control group (P 0.05). (2)For LADA patients, ab-normal thyroid function rate in patients with thyroid antibody detection positive rate was higher than the negative antibody detection, there was no significant difference between two groups (P>0.05).Conclusion By thyroid antibody detection, the risk of thyroid dysfunction in patients is big-ger, it''s easy to merge their own immune thyroid dis

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自身免疫性甲状腺疾病(AITD)是一种器官特异性自身免疫性疾病.近年研究发现维生素D具有调节免疫的作用.AITD患者存在维生素D缺乏,并可能与维生素D基因多态性有关.维生素D对AITD具有一定的防治作用.
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目的 研究系统性红斑狼疮(SLE)与自身免疫性甲状腺疾病(AITD)的关系,探讨AITD的发生与SLE病情活动度是否存在相关性.方法 以济宁医学院附属医院风湿免疫科2009年7月-2013年10月住院初治的220例SLE并筛查了甲状腺功能[游离甲状腺三碘原氨酸(FT3)、游离甲状腺素(FT4)、TSH]及甲状腺自身抗体[甲状腺球蛋白抗体(TgAb)和甲状腺过氧化物酶抗体(TPOAb)]的患者为研究对象,以正常者160名作为对照,比较SLE患者与正常者间AITD的患病率和甲状腺自身抗体阳性率;同时比较SLE合并AITD组与单纯SLE组患者的甲状腺自身抗体的阳性率,并分析两组患者与SLE疾病活动指标的相关性[以抗双链脱氧核糖核酸(dsDNA)抗体滴度、补体C3、C4、总补体活性、系统性红斑狼疮疾病活动指数(SLEDAI)评分作为SLE病情活动度指标].结果 220例SLE患者,合并AITD 45例(20.5％),其中甲状腺功能亢进6例(13.3％),甲状腺功能减退(包括亚临床型)26例(57.8％),桥本甲状腺炎13例(28.9％);甲状腺自身抗体阳性74例(33.6％);AITD患病率(20.5％)和甲状腺自身抗体阳性率(33.6％)均明显高于正常者(分别为3.13％和7.50％,均P＜0.05).SLE合并AITD组的甲状腺自身抗体的阳性率(62.2％)明显高于单纯SLE组(21.5％,P＜0.05),两组SLE患者
Objective To evaluate the incidence of autoimmune thyroid disease (AITD) in systemic lupus erythematosus (SLE) and examine the correlation between AITD and SLE activity.Methods The study group included 220 SLE patients with the screening of thyroid function (FT3,FT4,TSH) and antithyroid autoantibodies (TgAb,TPOAb) were hospitalized into Affiliated Hospital,Jining Medical College between July 2009 and October 2013.The control group included 160 healthy subjects.We compared the prevalence of AITD between SLE patients and normal controls and also the positive rate of anti-thyroid autoantibodies was observed.We also compared the positive rate of anti-thyroid autoantibodies between AITD in SLE and simple SLE group and also analyzed the correlation between two groups of patients and SLE activity (evaluated by the titer of anti-dsDNA,C3,C4,CH50,SLEDAI score).Results Among them,45 patients suffered from AITD (20.5％).There were hyperthyroidism (n =6,13.3％) and hypothyroidism (includ

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