血清AchRAb及补体在儿童重症肌无力中的水平及诊断价值  

Serum AchRAb and complement in children with myasthenia gravis and its diagnostic value

作　　者：王立利[1] 张淑敏[1] 王红芳[1] 王维[1] WANG Li-li;ZHANG Shu-min;WANG Hong-fang;WANG Wei(Department of Pediatric Internal Medicine,Tangshan Maternal and Child Health Hospital,Tangshan,Hebei 063000,China)

机构地区：[1]唐山市妇幼保健院儿内科,河北唐山063000

出　　处：《中国临床研究》2020年第10期1383-1386,共4页Chinese Journal of Clinical Research

摘　　要：目的探讨血清乙酰胆碱受体抗体(AchRAb)及补体在儿童重症肌无力中的水平及诊断价值。 方法选择2011年5月至2019年7月诊治的重症肌无力患儿80例作为病例组,选择同期进行体检的健康儿童80例作为对照组。检测血清AchRAb、补体3(complement3,C3)含量和外周血T淋巴细胞亚群[CD4^+(%),CD8^+(%)]水平,记录患儿的重症肌无力量化评分(QMGS)并进行相关性分析。 结果病例组的血清AchRAb、干扰素(IFN)-γ、肿瘤坏死因子(TNF)-α含量高于对照组,C3含量低于对照组,差异有统计学意义(P均<0.01)。病例组的CD4^+(%)高于对照组,CD8^+(%)低于对照组,差异有统计学意义(P<0.05,P<0.01)。病例组QMGS评分为18~31(24.19±2.18)分。Pearson相关分析显示,在重症肌无力患儿中,QMGS评分与Osserman分型、病程、AchRAb、IFN-γ、TNF-α、C3、CD4^+T细胞比例分别呈正相关性(P均<0.01);Logistic回归分析显示,AchRAb、IFN-γ、C3为儿童重症肌无力QMGS评分的独立影响因素(P<0.05,P<0.01)。 结论血清AchRAb、C3在儿童重症肌无力中呈异常增高,且与患儿的病情密切相关,AchRAb、IFN-γ、C3为影响儿童重症肌无力病情的重要因素。Objective To explore the levels of serum acetylcholine receptor antibody(AchRAb) and complement and its diagnostic value in children with myasthenia gravis.Methods Eighty myasthenia gravis children treated from May 2011 to July 2019 were selected as case group,and 80 healthy children undergoing physical examination in the same period were served as control group.The levels of serum AChRab,complement 3(C3) and peripheral blood T lymphocyte subsets [CD4+(%) and CD8+(%)]were detected,and quantitative myasthenia gravis score(QMGS) was recorded and analyzed to observe their relationship.Results The serum levels of AchRAb,IFN-γ and TNF-α in case group were statistically higher than those in control group,and C3 content was lower than that in control group(all P<0.01).Compared with control group,CD4+T cells increased,and CD8+T cells decreased in case group(P<0.05,P<0.01).In case group,QMGS was 18 to 31(24.19±2.18) points.Pearson correlation analysis showed that QMGS was positively correlated with Osserman classification,disease course and levels of AChRab,IFN-γ,TNF-α,C3 and CD4+T cell in myasthenia gravis children respectively(all P<0.01).Logistic regression analysis showed that AChRab,IFN-γ and C3 were the independent factors influencing QMGS in children with myasthenia gravis(P<0.05,P<0.01).Conclusions The abnormal levels of serum AchRAb and C3 are abnormally high in myasthenia gravis children,which are closely related to the patient′s condition.AchRAb,IFN-Υ,and C3 are the important factors influencing myasthenia gravis children.

关 键 词：重症肌无力 儿童 乙酰胆碱受体抗体 补体3 T淋巴细胞亚群 重症肌无力量化评分 

分 类 号：R593.2[医药卫生—内科学]