肌联蛋白抗体在诊断胸腺瘤重症肌无力中的意义  

The significance of Titin antibody in diagnosing myasthenia gravis with thymoma

作　　者：陈向军[1] 吕传真[1] 乔健[1] 陈志明[2] 姚亚其[2] 

机构地区：[1]复旦大学附属华山医院神经科,上海200040 [2]复旦大学附属华山医院胸外科,上海200040

出　　处：《中华医学杂志》2001年第18期1118-1120,共3页National Medical Journal of China

摘　　要：目的　探讨肌联蛋白抗体 (Titin ab)在诊断胸腺瘤重症肌无力 (MGT)中的意义。方法　采用ELISA法检测 73例不同病理类型MGT和 5 8例不伴胸腺瘤重症肌无力 (NTMG)患者血清中Titin ab和乙酰胆碱受体抗体 (AChR ab)的水平。结果　MGT组患者血清中Titin ab阳性率为 76 .7% ,明显高于NTMG组、其他疾病对照组和正常人组 (P均 <0 .0 1) ;Titin ab诊断MGT的敏感性低于胸腺CT/MR ,但特异性高于后者 (P <0 .0 5 ) ;Titin ab阳性率与不同胸腺瘤病理类型有关 ,其中上皮细胞型胸腺瘤组最高 (95 .1% ) ;与胸腺瘤Masaoka病理分期无关 (P >0 .0 5 ) ;MGT患者Titin ab与AChR ab有明显相关性 (r=0 .496 ,P <0 .0 1) ,而MGH患者则不明显 (r=0 .385 ,P >0 .0 5 )。结论　Titin ab是一种诊断MGT(尤其是上皮细胞型胸腺瘤 )较为敏感、特异、简便易行的实验室参数 。Objective To investigate the clinical significance of Titin antibody (Titin ab) in diagnosing myasthenia gravis with thymoma (MGT). Methods Titin ab and acetylcholine receptor antibody (AChR ab) in the sera of 73 MGT patients with different thymic pathological patterns and 58 MG patients without thymoma (NTMG) were detected by ELISA. Results The positive rate of Titin ab in MGT group was 76 7%, significantly higher than those of NTMG group, other neurologic diseases group and healthy control group ( P <0 01). The sensitivity of Titin ab in diagnosis of MGT was significantly lower than that of CT scan or MR of thymus ( P <0 05), but the specificity of Titin ab in diagnosis of MGT was significantly higher than that of CT scan or MR of thymus ( P <0 05). The positive rate of Titin ab was mainly related to the thymic pathology and was the highest in the thymic epithelial thymoma (TET) subgroup (95 1%). There was no significant correlation between the positive rate of Titin ab and the Masaoka′s stage of thymoma ( P >0 05). The titer of Titin ab was highly correlated to the titer of AChR ab in MGT group ( r =0 496, P <0 01), but not in MGH group ( r =0 385, P >0 05). Conclusion Detection of Titin ab is a rather sensitive, specific, handy method in diagnosis of MGT (especially TET). It may play an important role in the pathogenesis of MGT.

关 键 词：重症肌无力 自身抗体 胸腺瘤 肌联蛋白抗体 诊断 

分 类 号：R746.1[医药卫生—神经病学与精神病学]