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检测重症肌无力(MG)患者外周血CD28-T细胞亚群的变化,并探讨其临床意义。收集46例MG患者和35例健康对照(HC)外周血标本,采用免疫荧光染色和流式细胞术检测外周血CD4+CD28-和CD8+CD28-T细胞亚群。结果显示,MG患者和HC比较,前者CD28表达下调,CD4、CD8表达无差异;MG患者CD4+CD28-T细胞亚群(13.53%±6.31%)较HC(9.24%±4.62%)异常升高(P=0.001),而CD8+CD28-T细胞亚群(39.22%±11.91%)较HC(48.41%±13.63%)显著下降(P=0.002);全身型MG(GMG)和并发胸腺异常的MG患者中,CD4+CD28-T细胞亚群比例分别较眼肌型MG(OMG)和正常胸腺MG患者升高,而CD8+CD28-T细胞亚群百分比明显下降;QMGS评分与CD4+CD28-T细胞亚群呈正相关(r=0.4113,P=0.0045),而与CD8+CD28-T细胞亚群呈负相关(r=-0.3989,P=0.0060);激素治疗后伴随CD4+CD28-T细胞比例下降(P=0.018)和CD8+CD28-T细胞比例升高(P=0.018)。本研究发现,MG患者外周血CD4+CD28-T细胞亚群比例升高和CD8+CD28-T细胞亚群比例下降与疾病严重程度、治疗反应密切相关,且在不同临床分型的MG患者中存在差异性变化。上述提示CD28-T细胞亚群的异常变化可能参与了MG的免疫病理进程。
To detect the changes of CD28-T cell subsets in peripheral blood of patients with myasthenia gravis (MG) and to explore its clinical significance. Peripheral blood samples of 46 patients with MG and 35 healthy controls (HC) were collected. The subsets of CD4 + CD28- and CD8 + CD28-T cells in peripheral blood were detected by immunofluorescence staining and flow cytometry. The results showed that compared with HC patients, the expression of CD28 was down-regulated and the expression of CD4 and CD8 was no difference in MG patients. The abnormality of CD4 + CD28-T cell subsets (13.53% ± 6.31%) in MG patients was significantly higher than that in HC patients (9.24% ± 4.62% (P = 0.001). The CD8 + CD28-T cell subsets (39.22% ± 11.91%) were significantly lower than HC (48.41% ± 13.63% MG patients, the proportion of CD4 + CD28-T cell subsets were significantly higher than that of OMG and MG patients, while the percentage of CD8 + CD28-T cell subsets was significantly decreased. The scores of QMGS and CD4 + CD28- T lymphocyte subsets were positively correlated (r = 0.4113, P = 0.0045), but negatively correlated with CD8 + CD28-T lymphocyte subsets (r = -0.3989, P = 0.0060) The proportion decreased (P = 0.018) and the proportion of CD8 + CD28-T cells increased (P = 0.018). The study found that MG patients with increased proportion of CD4 + CD28-T lymphocyte subsets and CD8 + CD28-T cell subsets decreased with the severity of the disease, the treatment response is closely related to, and in different clinical classification of MG patients There are differences in change. The above suggests that aberrant changes of CD28-T cell subsets may be involved in the immunopathological process of MG.