血清Titin-Ab与AChR-Ab对重症肌无力患者的临床诊断价值  

Clinical diagnostic value of serum Titin-Ab and AChR-Ab in patients with myasthenia gravis

作　　者：陆梦如[1] 钊岩 李何鹏[1] 唐健[1] 梁津瑜 LU Meng-ru;ZHAO Yan;LI He-peng;TANG Jian;LIANG Jin-yu(Department of Neurology,the Second Affiliated Hospital of Guangxi Medical University,Nanning 530007,Guangxi;The Third Hospital of Ji nan,Ji nan 250132,Shandong,China)

机构地区：[1]广西医科大学第二附属医院神经内科,广西南宁530007 [2]济南市第三人民医院,山东济南250132

出　　处：《川北医学院学报》2022年第6期759-762,共4页Journal of North Sichuan Medical College

基　　金：广西壮族自治区卫生健康委员会科研课题(Z20210437)。

摘　　要：目的:探讨血清连接素抗体(Titin-Ab)与乙酰胆碱受体抗体(AChR-Ab)检测对重症肌无力(MG)患者的诊断价值。方法:前瞻性纳入86例MG患者(MG组)作为研究对象,根据改良0sserman临床分型将其分为眼肌型组(n=51)和全身型组(n=35),并择取80名同期健康体检对象作为对照组。检测所有研究对象血清Tintin-Ab及AChR-Ab,分析各组间血清Tintin-Ab及AChR-Ab阳性率差异及其对MG的诊断价值。结果:MG组患者血清Titin-Ab、AChR-Ab阳性率均高于对照组(P<0.05);全身型患者AChR-Ab阳性率高于眼肌型(P<0.05),但两组间血清Titin-Ab阳性率比较,差异无统计学意义(P>0.05);全身型组患者中,ⅡA型8例,ⅡB型20例,Ⅲ型+Ⅳ型7例,不同Osserman分型患者血清Titin-Ab和AChR-Ab阳性率比较,差异均无统计学意义(P>0.05);两指标联合诊断MG的灵敏度高于单独诊断(χ^(2)=37.979,P<0.05)。结论:MG患者血清Titin-Ab和AChR-Ab阳性率升高,两指标联合检测,对MG诊断具有较高的灵敏度及准确率。Objective:To explore the clinical diagnostic value of serum connexin antibody(Titin-Ab)and acetylcholine receptor antibody(AChR-Ab)in patients with myasthenia gravis(MG).Methods:86 patients with MG were prospectively included in the study(MG group).According to the clinical classification of modified 0sserman,the patients were divided into eye muscle type group(n=51)and whole body type group(n=35),and 80 healthy subjects in the same period were selected as the control group.The serum Tintin-Ab and AChR-Ab of all subjects were detected,and the differences in the positive rates of serum Tintin-Ab and AChR-Ab between groups and their diagnostic value for MG were analyzed.Results:The positive rates of serum Titin-Ab and AChR-Ab in the MG group were higher than those in the control group,and the differences were statistically significant(P<0.05).The positive rate of AChR-Ab in patients with whole body type was significantly higher than that in patients with eye muscle type(P<0.05),there was no significant difference in the positive rate of serum Titin-Ab between the whole body type group and the eye muscle type group(P>0.05).There were 8 cases of type IIA,20 cases of type IIB and 7 cases of type Ⅲ + Ⅳ in whole body type group,there was no significant difference in the positive rates of serum Titin-Ab and AChR-Ab between MG patients with different Osserman types(P>0.05).The sensitivity of the combined diagnosis of myasthenia gravis was higher than that of AChR-Ab,Titin-Ab alone(χ^(2)=37.979,P<0.05).Conclusion:The positive rates of serum Titin-Ab and AChR-Ab in MG patients increased,and the combined detection of the two indexes has high sensitivity and accuracy in the diagnosis of MG.

关 键 词：重症肌无力 血清连接素抗体 乙酰胆碱受体抗体 联合诊断 

分 类 号：R746.1[医药卫生—神经病学与精神病学]