| Objective:By comparing the menopausal transition hashimoto thyroiditis patients and normal healthy perimenopausal women estrogen,FT3,FT4,TSH,TPO-Ab,expression level of TG-Ab,17,and helper T cells in peripheral blood of regulatory T cells,the proportion of CD4+ lymphocytes level,analysis of women estrogen level changes of T lymphocyte subsets and influence on hashimoto thyroiditis immune pathogenesis,the diagnosis and treatment of hashimoto’s thyroiditis with new ideas.Methods:Perimenopausal female patients admitted to the Department of Breast and Thyroid Surgery of Jilin Provincial People’s Hospital from June 2019 to December 2020 were selected as the experimental group.Thirty patients who met the diagnostic criteria of Hashimoto’s thyroiditis were selected as the experimental group.All patients in this group were first diagnosed or had not received any previous treatment.Another 30 healthy perimenopausal women were selected as a control group.All patients participated in the trial on a voluntary basis.Serum TSH,FT3,FT4,TPO-Ab and Tg-Ab were measured in both groups,and the percentages of CD4+T lymphocytes,helper T lymphocytes 17 and regulatory T lymphocytes in peripheral blood between perimenopausal Hashimoto thyroiditis patients and normal perimenopausal women were compared by flow cytometry,and the above data were compared and analyzed respectively.Results:(1)The comparison of estrogen levels between the two groups showed that,although both were within the normal range,the estrogen level of perimenopausal Hashimotothyroiditis patients(37.39±13.28 pg/ml)was significantly higher than that of the healthy control group(19.87±11.85 pg/ml)(p< 0.05).(2)Two groups in the total CD4 + T lymphocyte ratio has no obvious difference(p>0.05),and Th17 cells in peripheral blood in the menopausal transition hashimoto thyroiditis expression levels in the group of patients(1.79±0.93 %)is significantly higher than healthy controls(0.75 ± 0.24 %)(p< 0.05),Treg cells in the menopausal transition hashimoto thyroiditis expression levels in the group of patients(4.06±1.09 %),significantly lower than the control group(7.09±1.53 %)(p< 0.05).(3)There was no significant difference in serum FT3 and FT4 levels between the two groups(p> 0.05).However,the expression level of serum TSH in perimenopausal Hashimamoto thyroiditis group(8.10 ± 2.25 m U/L)was significantly higher than that in healthy control group(2.64±1.01 m U/L)(p< 0.05).The levels of TPO-Ab and TG-Ab in perimenopausal Hashimoto thyroiditis group were significantly higher than those in healthy control group(p< 0.05).(4)In perimenopausal patients with Hashimoto’s thyroiditis,the proportion of Treg decreased with the increase of estrogen level,showing a negative correlation trend,while the proportion of Th17 showed a positive correlation trend with estrogen level.However,there was no significant correlation between estrogen levels and FT3,FT4 and TSH levels in perimenopausal Hashimoto thyroiditis patients.(5)The level of Th17 in peripheral blood of perimenopausal patients with Hashimoto’s thyroiditis was positively correlated with the level of TPO-Ab and TG-AB,while the level of Treg was negatively correlated with the level of TPO-Ab.Conclusion:1.Increased estrogen levels may affect disease progression in perimenopausal Hashimoto’s thyroiditis patients.2.Under the action of estrogen,the ratio of Th17 and Treg could be unbalanced.The expression level of Th17 cells in the perimenopausal HT patients was significantly higher than that in the healthy control group,while the expression level of Treg cells was significantly lower than that in the healthy control group.Moreover,Th17 cells were positively correlated with the levels of autoantibodies(TPO-Ab and TG-Ab).It is suggested that the increased expression level of Th17 cells and the decreased expression level of Treg cells are related to the incidence of Hashimoto’s thyroiditis.It may be that the immune imbalance of the two cells leads to the increased thyroid autoantibody level,thus affecting the disease progression of Hashimoto’s thyroiditis.3.Reducing the level of Th17 cells and increasing the level of Treg cells may be a new method for the treatment of Hashimoto’s thyroiditis. |
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