血清可溶性CTLA-4表达与重症肌无力的相关性研究  

Increased production of circulating soluble co-stimulatory molecule CTLA-4 in patients with myas- theula gravis

作　　者：郑维红[1] 王文杰[1] 林晓芳[1] 刘肇绩[1] 

机构地区：[1]厦门大学附属中山医院神经内科,361004

出　　处：《中华微生物学和免疫学杂志》2013年第7期513-517,共5页Chinese Journal of Microbiology and Immunology

摘　　要：目的探讨血清可溶性细胞毒性T淋巴细胞相关抗原-4（CTLA-4）表达与福建地区重症肌无力（myastheniagravis，MG）患者的相关性。方法ELISA法检测福建地区80例MG患者（MG患者分为激素未治疗组及激素治疗组，且激素治疗组进-步分为免疫抑制剂治疗组和胸腺切除组）和80例正常对照组血清可溶性CTLA-4（sCTLA-4）水平。结果MG激素未治疗组、激素治疗组的sCTLA-4均高于正常对照组[（6．03±3．58）ng／ml、（3．44±2．36）ng／ml vs（0．49±0．95）ng／m1]，它们之间的差别具有统计学意义（χ2=100．67，P〈0．001）；其中激素治疗组sCTLA-4表达水平高于正常对照组（z=-9．03，P〈0．001），而MG激素未治疗组sCTLA-4表达高于激素治疗组（Z=-3．37，P=0．001）；并且激素未治疗组激素治疗前后血清sCTLA-4水平差异有统计学意义（t=3．10，P=0．005）；胸腺切除术后sCTLA-4低于手术前（z=-2．21，P=0．04），而免疫抑制剂治疗前后差异却没有统计学意义（z=-1．26，P=0．21）。结论sCTLA-4参与MG的发病机制，激素治疗、胸腺切除治疗减少sCT-IA4表达。Objective To investigate the role of soluble cytotoxic T-lymphocyte associated antigen- 4 （sCTLA-4） in the pathogenesis of myasthenia gravis （MG） in Fujian province. Methods A total of 80 patients with MG and 80 sex- and age-matched healthy controls were enrolled in the study. MG patients were divided into non-glucocorticoid treatment group and glucocorticoid treatment group, and the latter was further divided into immunosuppressive therapy group and thymusectomy group. Concentrations of sCTLA-4 in ser- ums from above mentioned groups were measured by enzyme-linked immunosorbent assay （ELISA）. Results The concentrations of sCTLA-4 in both non-glucocorticoid treatment group and glucocorticoid treatment group were significantly higher than those in the healthy control group （6.03 ng/ml±3.58 ng/ml, 3.44 ng/ml± 2.36 ng/ml vs. 0.49 ng/ml±0.95 ng/ml） （X2 = 100.67, P〈0.001 ）, but sCTLA-4 concentrations in glu- cocorticoid treatment group were lower than those in non-glucocorticoid treatment group （ Z = - 3.37, P = 0.001 ）. With the treatment of glucocorticoid, the sCTLA-4 concentrations were reduced （6.03 ng/ml ± 3.58 ng/ml vs. 4.56 ng/ml±2.08 ng/ml; t=3.10, P=0.005）, and the concentrations of sCTLA-4 were also decreased after thymusectomy therapy （3.86 ng/ml±2.53 ng/ml vs. 2.59 ng/ml±2. 37 ng/ml; Z= -2.21, P=0.04）. However, there was no significant difference in the concentrations of sCTLA-4 before and after immunosuppressive drugs treatment （ Z = - 1.26, P = 0.21 ）. Conclusion The concentration of sCTLA-4 was increased in patients with MG, but with the treatment of glucocorficoid or thymusectomy it could be reduced.

关 键 词：重症肌无力 细胞毒性T淋巴细胞相关抗原-4 

分 类 号：R74[医药卫生—神经病学与精神病学]