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目的探讨Fas介导的细胞凋亡与重症肌无力(MG)合并甲状腺功能亢进(甲亢)机制的关系。方法对2007年10月至2009年12月中山大学附属第五医院收治的17例MG患者及13名健康对照者进行研究,采用流式细胞技术检测外周血T淋巴细胞表面CD4、CD8及Fas的表达。结果合并甲亢的MG患者(5例)中眼肌型MG比例高于无合并甲亢MG组(40.0%对16.7%),胸腺增生及胸腺瘤的发生率均比无合并甲亢MG组低(前者20%对50%;后者0对25%),但差异无统计学意义。合并甲亢MG组患者外周血T淋巴细胞中CD4+CD8-细胞比例比对照组高(P=0.034)。合并甲亢MG组外周血T淋巴细胞中CD4+Fas+、CD4+CD8+Fas+细胞比例比对照组高,CD4+CD8+Fas+细胞比例比无合并甲亢MG组高,差异有统计学意义(均P<0.05)。结论甲亢在MG中发生率较高;合并甲亢的MG患者外周血CD4+T淋巴细胞中Fas的表达升高,可能与MG合并甲亢的发病机制有关。
Objective To investigate the relationship between Fas-mediated apoptosis and myasthenia gravis (MG) complicated with hyperthyroidism (hyperthyroidism). Methods 17 cases of MG patients and 13 healthy controls who were admitted to the Fifth Affiliated Hospital of Sun Yat-sen University from October 2007 to December 2009 were studied. Flow cytometry was used to detect the expression of CD4, CD8 and Fas on peripheral blood T lymphocytes expression. Results The proportion of MG in MG patients with hyperthyroidism (5 cases) was higher than that in MG without MG (40.0% vs 16.7%), and the incidence of thymic hyperplasia and thymoma was lower than that of MG without hyperthyroidism % To 50%; the latter 0 to 25%), but the difference was not statistically significant. The proportion of CD4 + CD8- cells in peripheral blood T lymphocytes in MG patients with hyperthyroidism was higher than that in control group (P = 0.034). The proportion of CD4 + Fas + and CD4 + CD8 + Fas + cells in peripheral blood T lymphocytes of hyperthyroidism MG group was higher than that of control group, and the proportion of CD4 + CD8 + Fas + cells was higher than that of MG group without hyperthyroidism (all P < 0.05). Conclusion The incidence of hyperthyroidism in MG is high. The expression of Fas in peripheral blood CD4 + T lymphocytes of MG patients with hyperthyroidism is increased, which may be related to the pathogenesis of MG complicated with hyperthyroidism.