论文部分内容阅读
目的探讨重症肌无力(MG)相关抗体与 MG 的临床关系。方法采用酶联免疫吸附法(ELISA)检测74例 MG 患者血清乙酰胆碱受体抗体(AChR-ab)、肌联蛋白抗体(Titin-ab)和利阿诺碱受体抗体(RyR-ab)水平。结果 AChR-ab、Titin-ab 和 RyR-ab 在所有 MG 患者中阳性率分别为77.0%(57/74)、39.2%(29/74)和32.4%(24/74),3种抗体总阳性率为93.2%(69/74)。在 MG 合并胸腺瘤的21例患者中阳性率分别为76.2%(16/21)、71.4%(15/21)和52.4%(11/21),3种抗体总阳性率为95.6%(20/21)。与早发患者相比,晚发患者中 Titin-ab 和 RyR-ab 水平明显升高[早发患者:23.1%(12/52)和25.0%(13/52),晚发患者:77.3%(17/22)和50.0%(11/22),P<0.01]。按改良 Osserman 分型症状较重者 Titin-ab(X~2=16.094,P=0.001)和 RyR-ab(X~2=11.226,P=0.011)阳性率亦高,Titin-ab 和 RyR-ab 有明显相关性(r=0.380,P=0.001)。结论 Titin-ab 和 RyR-ab 检测有助于 MG 合并胸腺瘤的诊断,与影像学检查结合可以提高 MG 合并胸腺瘤诊断的特异性和敏感性;Titin-ab 和 RyR-ab 的水平还可作为随诊和评估 MG 患者预后的指标。这两种抗体的产生过程及其作用机制有待进一步研究。
Objective To investigate the clinical relationship between myasthenia gravis (MG) -related antibodies and MG. Methods Serum levels of AChR-ab, Titin-ab and RyR-ab in 74 patients with MG were measured by enzyme linked immunosorbent assay (ELISA). Results The positive rates of AChR-ab, Titin-ab and RyR-ab in all MG patients were 77.0% (57/74), 39.2% (29/74) and 32.4% (24/74), respectively. The rate was 93.2% (69/74). The positive rates of the three antibodies were 76.2% (16/21), 71.4% (15/21) and 52.4% (11/21) respectively in 21 patients with MG thymoma. The total positive rates of the three antibodies were 95.6% (20 / twenty one). The levels of Titin-ab and RyR-ab were significantly higher in late-onset patients compared with those in early-onset patients (23.1% (12/52) and 25.0% (13/52) in early onset patients and 77.3% 17/22) and 50.0% (11/22), P <0.01]. The positive rates of Titin-ab (X ~ 2 = 16.094, P = 0.001) and RyR-ab (X ~ 2 = 11.226, P = 0.011) There was a significant correlation (r = 0.380, P = 0.001). Conclusion The detection of Titin-ab and RyR-ab is helpful for the diagnosis of MG complicated with thymoma. The combination of imaging with the examination of Titin-ab and RyR-ab can improve the specificity and sensitivity of the diagnosis of MG complicated with thymoma. The levels of Titin-ab and RyR- Follow-up and assessment of prognosis of patients with MG indicators. These two kinds of antibody production process and its mechanism needs further study.