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Graves病患者血管内皮细胞损伤的研究

门剑龙1,任静2,李刚3   

  1. 1. 天津医科大学总医院；天津大学，天津市生物医学检测技术与仪器重点实验室
    2. 天津医科大学总医院
    3. 天津大学
  • 收稿日期:2010-07-09 修回日期:2010-08-29 出版日期:2011-07-15 发布日期:2011-07-15
  • 通讯作者: 门剑龙

Study on the injury with endothelial cells of the vascular in the patients with Graves.

  • Received:2010-07-09 Revised:2010-08-29 Published:2011-07-15 Online:2011-07-15
  • Contact: Men Jianlong

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摘要： 摘要 目的 研究Graves病患者血管内皮祖细胞及内皮细胞损伤标志物的水平变化，探讨其血管内皮细胞的损伤机制。方法 采用IL ACL-9000型血液凝固仪测定vWF:Ag。采用流式细胞仪计数EPCs，采用免疫磁珠法测定CEC。采用ADVIA Centaur 化学发光免疫分析仪测定FT3和FT4。结果 患者组vWF:Ag、CEC高于对照组，EPCs低于对照组，差异有统计学意义（P<0.01）。与对照组比较，未合并房颤的Graves病患者组CEC水平变化无统计学意义（q＝1.35，P>0.05），vWF:Ag水平高于对照组（q＝21.77），EPCs低于对照组（q＝8.89），差异有统计学意义（P<0.01）。合并房颤的Graves病患者组vWF:Ag和CEC水平高于未合并房颤的患者组（q＝19.92，q＝16.05），EPCs低于未合并房颤的患者组（q＝3.89），差异有统计学意义（P<0.01）。未合并房颤患者FT3与vWF:Ag显著正相关（P<0.01），与EPCs显著负相关（P<0.01）；合并房颤患者FT3和FT4与各指标均不相关。结论 Graves病患者存在血管内皮损伤和功能紊乱，内皮祖细胞减少导致血管修复能力减弱。合并房颤的患者由于外周血管中内皮细胞大量脱落，内皮祖细胞数量进一步减少，使其血管内皮损伤程度比未合并房颤的患者更为严重且无法得到有效修复，使患者血栓风险增加。

关键词: Graves病, 甲状腺功能亢进, 内皮祖细胞, 循环内皮细胞, 紊乱

Abstract: Abstract Objective Study on the change of the level of the endothelial progenitor cells and circulating endothelial cell, and investigate the damage and disorder mechanism of the vascular endothelial system in the patients with Graves. Methods The von Willebrand Factor antigen(vWF:Ag) was measured using the IL ACL-9000 blood coagulation instrument. The flow cytometry was used to measure the circulating endothelial cell（CEC）and endothelial progenitor cells（EPCs）. The free-triiodothyronine（FT3）and free thyroxin（FT4）were determined using the ADVIA Centaur chemiluminesent immunoassay analyzer. Results Compared the patients group with the control, the level of the vWF:Ag and CEC were increased obviously and EPCs was decreased remarkably in the Graves patients group（P<0.01）; CEC had no change（q＝1.35，P>0.05）, vWF:Ag（q＝21.77） was increased and EPCs（q＝8.89） was decreased siginficantly in the patients group(which had not combined with atrial fibrillation)（P<0.01）. Compared the Graves patients group(which had not combined with atrial fibrillation) with the patients group (which had combined with atrial fibrillation), vWF:Ag and CEC were increased（q＝19.92，q＝16.05）, EPCs was decreased significantly（q＝3.89）（P<0.01） in the patients group (which had combinated atrial fibrillation). There was strong positive relationship between FT3 and vWF:Ag, and negative relationship between FT3 and EPCs（P<0.01） in the patients group(which had not combinated atrial fibrillation); there was no relationship in the patients group (which had combinated atrial fibrillation). Conclusion There was the damage and dysfunction in the Graves patients, the decrease of the level of the EPCs led the ability of the vascular repair to weakness. Lots of the endothelial cell shed from the vascular wall, and the EPCs was lower in the patients which combined with atrial fibrillation, it made the extent of the damaged vascular endothelial more serious and the repair became more difficult., and it brought the worse thrombosis risk.

Key words: Graves, hyperthyroidism, endothelial progenitor cells, circulating endothelial cell, disorder