重症肌无力患者血清低密度脂蛋白受体相关蛋白4抗体的检测及其临床意义  

Detection of low-density lipoprotein receptor-related protein 4 antibodies of myasthenia gravis and its clinical significances

作　　者：李媛[1] 楚兰[1] 张艺凡[1] 蔡刚[1] 贺电[1] 徐竹[1] 朱英武[1] 况时祥[2] 夏聪[3] 高洁[3] 

机构地区：[1]贵州医科大学附属医院神经内科,贵阳550004 [2]贵阳中医学院第二附属医院神经内科 [3]贵州医科大学神经病学教研室

出　　处：《中华神经科杂志》2015年第11期980-983,共4页Chinese Journal of Neurology

基　　金：贵州省科学技术基金项目（2015GZ64099）

摘　　要：目的检测重症肌无力（MG）患者血清低密度脂蛋白受体相关蛋白4抗体（LRP4-ab）含量，并分析该抗体阳性患者的临床特点。方法共纳入116例MG确诊患者为病例组，40例其他神经免疫疾病患者及40名健康体检者为对照组，采用细胞分析的方法检测LRP4-ab。结果（1）病例组中共发现LRP4-ab阳性患者2例（1．7％）。所有对照组血清中均未发现LRP4-ab。（2）LRP4-ab阳性MG患者均为同一居住地的年轻女性；分型为OssermanI型，且伴有胸腺异常；经乙酰胆碱酯酶抑制剂及小剂量糖皮质激素治疗后均获得稳定缓解。结论发现2例LRP4-ab阳性的MG患者，提示MG可能存在着另一种发病机制。同时，根据该类患者的免疫学特点采用个体化的治疗方案可能对临床诊疗有着重要意义。Objective To test whether myasthenia gravis （MG） patients have low-density lipoprotein receptor-related protein 4 （LRP4） antibodies in serum, and to evaluate its clinical characteristics. Methods This study included 116 patients with MG, 40 patients with other neurological diseases, and 40 healthy control subjects. For the detection of LRP4 antibody, a cell based assay method was used. Results （ 1 ） LRP4-ab was detected in 2 of 116 patients （ 1.7% ） with MG. No LRP4 antibodies were identified in sera from other MG subtypes and control subjects. （2）The cfinieal characteristics of the 2 LRP4-MG patients were studied. Both of them had same ethnic background and presented thymic changes and isolated ocular symptoms （ Osserman I ）. They got full remission after treated with aeetylehdinest erase inhibitor and small dose prednisone. Conclusions We found 2 LRP4-ab positive in the sera of MG patients in Guizhou, China. These findings may reminder different pathogenesis in MG patients and give advises to special treatments as different subtypes.

关 键 词：重症肌无力 LDL受体相关蛋白质类 自身抗体 

分 类 号：R746.1[医药卫生—神经病学与精神病学]