胸腺切除术后应用免疫抑制剂治疗重症肌无力的分析研究  

Clinical observation for the treatment of myasthenia gravis with immunosuppressive agents after thymusectomy

作　　者：乞国艳[1] 郑旭光[2] 杨红[1] 郄春菊 张太明[2] 刘慈[1] 顾姗姗[1] 

机构地区：[1]河北省石家庄市第一医院肿瘤科,050011 [2]河北省石家庄市第一医院心胸外科,050011

出　　处：《河北医药》2010年第18期2480-2481,共2页Hebei Medical Journal

摘　　要：目的探讨重症肌无力患者胸腺切除术后应用免疫抑制剂治疗的CD4+CD25+Tr细胞百分率和乙酰胆碱受体抗体的变化。方法 A组(n=34)重症肌无力患者胸腺切除术后应用免疫抑制剂组;B组(n=35)重症肌无力患者胸腺切除后未应用免疫抑制剂组;用流式细胞仪计数外周血A、B2组治疗前和治疗后6个月的CD4+CD25+Tr细胞的百分率和酶联免疫吸附法检测乙酰胆碱受体抗体(AchR-Ab),应用许氏临床评分法对病情的严重程度和转归进行评定。结果 A、B2组比较CD4+CD25+Tr细胞百分率、乙酰胆碱受体抗体(AchR-Ab)、临床相对计分在治疗后6个月差异有统计学意义(P<0.01)。结论 HTK胸腺切除后应用免疫抑制剂6个月后,重症肌无力患者的CD4+CD2+5Tr细胞的百分率明显增高和AchR-Ab明显降低,肌无力症状稳定缓解。Objective To obseve the changes of CD4＋CD25＋Tr cell and AchR-Ab in the treatment of myasthenia gravis （ MG ） with immunosuppressive agents after thymusectomy. Mathods 34 patients with myasthenia gravis in group A were treated with immunosuppressive agents after thymusectomy,however,the other 35 patients in group B were not treated with immunosuppressive agents after thymusectomy. The CD 4＋ CD 2＋5 Tr percentage before treatment and after 6 - month treatment was detected by flow cytometry,and AchR-Ab from peripheral blood was determined by ELISA. The clinical severity and prognosis of MG were evaluated by Xu’s clinical scoring system. Results After 6 - month treatment there were significant difference in CD 4＋ CD 2＋5 Tr percentage,AchR-Ab and clinical relative score between group A and group B（ P 0. 01） . Conclusion The CD 4＋ CD 2＋5 Tr percentage is obviously increased after 6-month treatment with immunosuppressive agents after thymusectomy.

关 键 词：重症肌无力 CD4+CD25+Tr细胞(调节性T细胞) 免疫抑制剂 乙酰胆碱受体抗体 

分 类 号：R746.1[医药卫生—神经病学与精神病学]