重症肌无力患者免疫治疗过程中sIL-6R的动态演变  

Levels of soluble interleukin-6 receptor in serum of patients with myasthenia gravis in immunotherapy

作　　者：刘汝宏[1] 丛志强[2] 钟孟飞[3] 王海萍[2] 李江[2] 陈晓辉[3] 

机构地区：[1]北京航天总医院神经内科,北京100076 [2]青岛大学医学院附属医院神经内科,山东青岛266003 [3]胜利油田中心医院神经内科,山东东营257034

出　　处：《中风与神经疾病杂志》2011年第8期724-727,共4页Journal of Apoplexy and Nervous Diseases

摘　　要：目的探讨可溶性白细胞介素-6受体(sIL-6R)与重症肌无力(MG)的关系。方法应用酶联免疫吸附试验(ELISA)动态检测76例不同临床类型的MG患者(MG组)在免疫治疗过程中和48名健康对照者(NC组)血清sIL-6R水平,同时检测MG患者血清乙酰胆碱受体抗体(AChRab)水平,并对MG患者病情按许氏评分法进行量化。结果 (1)MG患者血清IL-6R水平明显高于NC组(P<0.01);其中病程>1年组患者sIL-6R水平明显高于病程<6个月组(P<0.05),后者血清sIL-6R水平在免疫抑制治疗后明显低于治疗前(P<0.05)。(2)绝对评分≥31分者sIL-6R水平明显高于评分≤15分患者(P<0.01,及P<0.05);绝对评分≤30分者经免疫治疗后,评分较免疫治疗前明显降低(P<0.05),并且血清sIL-6R水平明显下降(P<0.05);单用皮质类固醇组在免疫治疗后,绝对评分和血清sIL-6R水平明显下降(P<0.05)。(3)血清sIL-6R水平与MG患者病情明显相关(R2=0.528)。结论 sIL-6R参与了MG的免疫发病过程,MG患者存在体液免疫功能紊乱;血清sIL-6R可反映MG免疫治疗的效应,血清sIL-6R可作为观察MG病情变化的指标。Objective To investigate the clinical significance of soluble interleukin-6 receptor（sIL-6R） in myasthenia gravis（MG）.Methods The serum levels of sIL-6R were detected by enzyme linked immunosorbent assay（ELISA） in 76 MG patients with different clinical types（MG group） and 48 normal controls（NC group）.Acetycholine receptor antibody（AChRab） was parallelly examined in MG patients.MG group was subdivided into four subgroups according to their absolute scores rated by Xu＇s scoring system.Results（1）The levels of sIL-6R in the serum of MG patients were significantly higher than those of NC group（P〈0.01,or P〈0.05）,and sIL-6R was increased more obviously in the cases whose course were more than one year than within six months（P〈0.05）,in which the level of sIL-6R was decreased after immunochemotherapy.（2）The levels of sIL-6R in patients whose absolute scores over 30 were higher than those with scores between 1~15（P〈0.01,or P〈0.05）.The absolute scores and the level of sIL-6R in the cases whose absolute scores under 30 were significantly decreased after immunochemotherapy（P〈0.05）.Steroid therapy decreased obviously the myasthenic scores and the levels of sIL-6R in MG patients（P〈0.05）.（3）There was logarithmic correlation between the serum level of sIL-6R and the myasthenic scores rated by Xu＇s scoring system.Conclusion sIL-6R plays a role in the immune pathogenesis of MG.There is an disorder of humeral immunity in MG patients.sIL-6R is a reliable parameter in evaluating the disabilities in MG patients.sIL-6R is useful in monitoring the effects of therapy in MG case.

关 键 词：重症肌无力 受体 可溶性 白细胞介素-6 免疫治疗 

分 类 号：R746.1[医药卫生—神经病学与精神病学]