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目的 探讨重症肌无力 (MG)患者外周血单个核细胞Bcl 2蛋白表达及其临床意义。方法 以流式细胞仪双标记免疫荧光方法测定 4 7例临床确诊的MG患者外周血T、B淋巴细胞Bcl 2蛋白表达和CD3+T细胞Bcl 2蛋白表达的平均荧光强度 (MFI)。结果 ( 1)MG组外周血CD3+、CD4 +、CD8+T淋巴细胞和CD19+细胞Bcl 2蛋白表达明显高于对照组 (P <0 .0 1) ,CD3+T细胞蛋白表达Bcl 2的MFI( 0 .572± 0 .177)亦明显高于对照组 ( 0 .170± 0 .147) (P <0 .0 1)。 ( 2 )MG组外周血CD3+、CD4 +、CD8+T淋巴细胞及CD19+细胞的Bcl 2蛋白表达与年龄无明显相关 ,而与临床严重程度绝对评分密切相关 (r=0 .63、0 .65、0 .61、0 .78,P <0 .0 5)。CD3+T细胞蛋白表达的MFI与MG患者病程相关密切 (r=0 .62 ,P <0 .0 1)。 ( 3)免疫抑制治疗后MG组临床严重程度绝对评分与淋巴细胞亚群Bcl 2蛋白表达、CD3+T细胞蛋白表达的MFI同步地较治疗前有明显下降 (P <0 .0 1)。结论 外周血淋巴细胞Bcl 2蛋白异常表达对MG发病及临床症状有重要作用。
Objective To investigate the expression of Bcl-2 protein in peripheral blood mononuclear cells in patients with myasthenia gravis (MG) and its clinical significance. Methods The mean fluorescence intensity (MFI) of Bcl 2 protein in peripheral blood T lymphocytes and Bcl 2 protein in CD3 + T cells in 47 patients with clinically proven MG were determined by flow cytometry double labeling immunofluorescence assay. Results (1) The expression of Bcl 2 protein in CD3 +, CD4 +, CD8 + T lymphocytes and CD19 + cells in MG group was significantly higher than that in control group (P <0.01). The MFI of CD3 + T cells in Bcl2 0. 572 ± 0.177) were also significantly higher than those in the control group (0.70 ± 0.147) (P <0.01). (2) The expression of Bcl-2 protein in CD3 +, CD4 +, CD8 + T lymphocytes and CD19 + cells in MG group was not related to age, but closely related to the absolute clinical severity score (r = 0.63,0.65 , 0 .61, 0 .78, P <0. 05). The MFI of CD3 + T cell protein expression was closely related to the course of MG patients (r = 0.62, P <0.01). (3) The absolute score of clinical severity of MG group after immunosuppressive therapy was significantly lower than that before treatment in both Bcl-2 protein and MFI of CD3 + T cells in lymphocyte subsets (P <0.01). Conclusion Abnormal expression of Bcl 2 in peripheral blood lymphocytes plays an important role in the pathogenesis and clinical symptoms of MG.