甲强龙冲击对重症肌无力患者外周血Treg及CD95的影响  

Effect of methylprednisolone stosstherapy on CD4＋CD25＋ regulatory T cells and CD95 levels in peripheral blood of patients with myasthenia gravis

作　　者：董礼全[1] 颜丽丽 王鹏飞[1] 耿娜[1] 高犇[1] 徐东[3] 潘旭东[4] 

机构地区：[1]威海市立医院神经内科,264200 [2]威海市妇幼保健院儿保科,264209 [3]山东大学医学院神经内科,济南250012 [4]青岛大学医学院神经内科,青岛266000

出　　处：《中华神经医学杂志》2016年第6期617-620,共4页Chinese Journal of Neuromedicine

摘　　要：目的检测甲强龙冲击对重症肌无力患者外周血CD4＋CD25＋调节性T细胞（Treg）及细胞凋亡因子CD95表达的影响及与不同临床疗效之间的关系。方法选择威海市立医院神经内科自2013年1月至2015年9月收治的重症肌无力患者（31例）及同期健康查体者（27例），采用流式细胞仪测定重症肌无力患者甲强龙冲击治疗前后和健康对照者外周血Treg与CD95表达的情况。结果经甲强龙冲击治疗后临床绝对评分≤3分并且相对评分≥0．5分患者外周血Treg百分率（13．39％±2．71％）高于健康对照者（8．35％±1．87％），差异有统计学意义（P〈0．05）。经甲强龙冲击治疗后绝对评分〉3分以及相对评分〈0．5分患者外周血Treg百分率（8．17％±1．31％）稍低于健康对照者（8．35％±1．87％），差异无统计学意义（P〉0．05）。经甲强龙冲击治疗后临床绝对评分≤3分并且相对评分≥0．5分患者外周血CD95百分率（36．47％±5．32％）与健康对照（35．28％±5．58％）差异无统计学意义（P〉0．05）。经甲强龙冲击治疗后绝对评分〉3分以及相对评分〈0．5分患者外周血CD95百分率（34．97％±5．12％）与健康对照（35．28％±5．58％）差异无统计学意义（P〉0．05）。结论甲强龙冲击后临床疗效明显好转的患者外周血Treg比率升高，CD95变化不明显。Objective To analyze the effect ofmethylprednisolone stosstherapy on CD4＋CD25＋ regulatory T cell （Treg） and apoptosis factor CD95 expressions in the external peripheral blood of myasthenia gravis （MG） patients and explore the influencing factors of different clinical efficacy. Methods Thirty-one patients with MG, admitted to our hospital from January 2013 to September 2015, were included in this study; and 27 normal subjects were selected as control group. Methylprednisolone stosstherapy was given to the patient group. Expressions of Treg and CD95 in peripheral blood were detected by flow cytometry before and after treatment. Results Treg percentage of patients whose clinical absolute scale scores less or equal than 3 points and relative scale scores higher than 0.5 after methylprednisolone stosstherapy （13.39%＋2.71%） was significantly higher than that of healthy controls （8.35%＋1.87%, P〈0.05）; Treg percentage of patients whose clinical absolute scale scores greater than 3 as well as relative scale scores less than 0.5 after methylprednisolone stosstherapy （8.17%＋1.31%） was slightly lower than that of healthy controls （P〉0.05）. CD95 percentage of patients whose clinical absolute scale scores less or equal than 3 points and relative scale scores higher than 0.5 after methylprednisolone stosstherapy （36.47%±5.32%） was not statistically different as compared with that of healthy controls （35.28%±5.58%, P〉0.05）, CD95 percentage of patients whose clinical absolute scale scores greater than 3 as well as relative scale scores less than 0.5 after methylprednisolone stosstherapy （34.97%±5.12%） was not statistically different as compared with that of healthy controls （P〉0.05）. Conclusion Treg ratio increases, CD95 change is not obvious in patients whose clinical curative effect is improved markedly after methylprednisolone stosstherapy.

关 键 词：重症肌无力 CD4+CD25+调节性T细胞 CD95 流式细胞检测 甲强龙 

分 类 号：R746.1[医药卫生—神经病学与精神病学]