新发病重症肌无力患者外周血IL-18、TGFβ-1水平与糖皮质激素疗效的研究  

The effect of glucocorticoid and level of IL-18 and TGFβ-1 in new onset patients with myasthenia gravis

作　　者：李晓峰[1] 郭远瑾[1] 王敏莉[1] 罗永坚[2] 腾晓茗[2] 李吕力[2] 梅元武[1] 

机构地区：[1]华中科技大学附属协和医院神经内科,武汉430022 [2]广西壮族自治区人民医院神经内科

出　　处：《卒中与神经疾病》2011年第2期93-95,共3页Stroke and Nervous Diseases

基　　金：广西自然科学基金(桂科自0339028);广西卫生厅中西药科技重点项目(GZKZ10-012)

摘　　要：目的探讨糖皮质激素(GC)对新发病重症肌无力(MG)患者外周血白介素18(IL-18)、转化生长因子β-1(TGFβ-1)水平及临床疗效的影响。方法采用ELISA法检测26例新发病重症肌无力患者GC治疗前、治疗2月后和30名健康对照组血清IL-18、TGFβ-1水平,肌无力严重程度和临床疗效判定采用临床绝对和相对记分法。结果 MG患者外周血清IL-18、TGFβ-1水平均高于健康对照组(P<0.05);GC治疗2月后MG患者IL-18水平显著下降(t=8.92,P<0.01),TGFβ-1水平升高(t=-6.66,P<0.05);GC治疗前后预后差的全身型MG患者IL-18水平始终高于预后好的眼肌型MG患者(P<0.05),MG患者IL-18、TGFβ-1变化值与临床相对评分无明显相关性(r=0.301、r=-0.386,P>0.05)。结论 GC可通过抑制IL-18、提高TGFβ-1血清分泌水平而有效调节MG患者细胞免疫功能。Objective To investigate the effect of glucocortieoid （GC） on the serum levels of interleukin-l8 （IL-18） and transforming growth faetor β-1 （TGFβ-1） in new onset patients with myasthenia gravis （MG）. Mktheds The serum levels of IL-18 and TGFβ-1 were measured in 26 patients with MG before and after treatment with GC and in 30 normal controls （NC） with ELISA. The absolute and relative scores of 26 patients with MG were rated by XU Xian-hao score system. Results The levels of IL-18 and TGFβ-1 of patients with MG were significantly higher than those of NC group. The serum levels of IL-18 were significantly decreased and the levels of TGFβ-1 were increased after 2 months treatment with GC. The levels of IL-18 in MG patients with bad prognosis was higher than that with better prognosis. There was not correlation between variation of IL-18 or TGFβ-1 concentrations and the relative scores of MG preand post-treatment. Condusions GC can effectively regulate the function of eeUular immunity by inhibiting the production of IL-18 and increasing secretion of TGFβ-1.

关 键 词：重症肌无力 糖皮质激素 白介素18 转化生长因子Β-1 

分 类 号：R746.1[医药卫生—神经病学与精神病学]