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目的探讨肌肉特异性酪氨酸激酶抗体(muscle specific tyrosine kinase antibody,MuSKAb)与血清抗体阴性重症肌无力(seronegative myasthenia gravis,SNMG)的关系。方法应用基因工程方法获得MuSK蛋白,建立MuSKAb的放射免疫法(IPA)检测体系。IPA法测定MG患者156例、健康对照组30例和非MG患者30例血清乙酰胆碱受体抗体(AChRAb)水平,测定34例SNMG患者血清及对照组血清MuSKAb水平。结果①在156例MG患者中,血清AChRAb阳性率为78.2%(122/156例),其AChRAb水平为(1.2703±0.8728)nmol/L,明显高于对照组的(0.2410±0.1098)nmol/L,P<0.01。②SPMG组病情严重程度、血清AChRAb水平明显高于SNMG组(P<0.01),SNMG组与SPMG组性别、发病年龄差异无统计学意义(P>0.05);③34例SNMG患者血清MuSKAb阳性率为0%(0/34例),但其血清MuSK-Ab水平(0.0283±0.0133)nmol/L明显高于对照组的(0.0141±0.0098)nmol/L,P<0.05。结论血清MuSKAb在中国人MG中较低。
Objective To investigate the relationship between muscle specific tyrosine kinase antibody (MuSKAb) and seronegative myasthenia gravis (SNMG). Methods The MuSK protein was obtained by genetic engineering and the radioimmunoassay (IPA) system was established. The serum levels of AChRAb in 156 patients with MG, 30 healthy controls and 30 non-MG patients were measured by IPA method. The serum levels of MuSKAb in 34 patients with SNMG were measured. Results ① In 156 MG patients, the positive rate of AChRAb was 78.2% (122/156) and the AChRAb level was (1.2703 ± 0.8728) nmol / L, which was significantly higher than that of the control group (0.2410 ± 0.1098 nmol / L , P <0.01. ② The severity of SPMG group and serum AChRAb level were significantly higher than SNMG group (P <0.01). There was no significant difference in gender and age between SNMG group and SPMG group (P> 0.05). ③ The positive rate of MuSKAb in 34 SNMG patients was 0 % (0/34 cases). However, the serum level of MuSK-Ab (0.0283 ± 0.0133 nmol / L) was significantly higher than that of the control group (0.0141 ± 0.0098 nmol / L, P <0.05). Conclusion Serum MuSKAb is lower in Chinese MG.