全血灌流吸附治疗重症肌无力的实验研究  

Treatment of myasthenia gravis with systemic hemoperfusion adsorption

作　　者：杨丽[1] 程焱[1] 

机构地区：[1]天津医科大学总医院神经内科,天津300052

出　　处：《中华急诊医学杂志》2004年第10期670-672,i001,共4页Chinese Journal of Emergency Medicine

基　　金：天津市社会发展计划项目 ( 0 3 3 1114 11)

摘　　要：目的　观察全血灌流免疫吸附治疗重症肌无力的疗效。方法　以电鳗乙酰胆碱受体α亚单位Ta183 2 0 0段多肽为免疫源建立实验性自身免疫性重症肌无力动物模型 ,用以纤维素为载体、色氨酸为配基的吸附剂IM MG对实验兔进行全血灌流吸附治疗 ,比较治疗前后临床症状、抗体滴度、神经电生理功能的变化。结果　IM MG灌流治疗 2h ,能清除 (4 8 5 4± 2 4 7) %的致病抗体 ,肌无力症状显著改善 ;3、 5、10Hz重复神经电刺激实验复合动作电位衰减率明显恢复 (P <0 0 5 ) ,从治疗前的 (2 1 88± 7 2 4 ) %、(2 3 88± 7 4 2 ) %和 (2 5 75± 5 97) %依次恢复到 (16 0 0± 6 78) %、 (16 88± 7 4 2 ) %和 (17 5 0± 7 5 8) %。结论　IM MG全血灌流吸附治疗能有效清除重症肌无力动物体内的致病抗体 ,并相应改善肌无力症状 ,提高神经肌肉电传导功能 。Objective To investigate the effects of systemic hemoperfusion adsorption in the treatment of myasthenia gravis.Methods Myasthenia gravis (MG)models in rabbits were produced by immunization with Tal83-200 and treated with systemic hemoperfusion.The clinical improvement was evaluated through clinical score,antibody titers,and changes in neuroelectrophysiological function.Results The pathogenic antibodies of Tal83-200 were removed by(48.54±2.47)% at 2 h after treatment.The attenuation percentage of compound muscle action potential at 3,5,10Hz in MG rabbits decreased from(21.88±7.24)%,(23.88±7.42)% and (25.75±5.97)% to (16.00±6.78)%,(16.88±7.42)% and (17.50±7.58)%,respectively.Conclusion Systemic hemoperfusion adsorption could remove pathogenic antibodies in MG effectively,and improve clinical manifestation and neuromuscular function.It may be considerated in the future for treating myasthenic crisis.

关 键 词：治疗 灌流 全血 重症肌无力 致病 抗体 IM 疫源 症状 实验兔 

分 类 号：R746.1[医药卫生—神经病学与精神病学] R735.7[医药卫生—临床医学]