摘要
目的：观察胸腺切除(Tx)术对重症肌无力(MG)病人的临床疗效及对T淋巴细胞亚型的影响。方法：用许氏评分法观察30例伴胸腺增生或胸腺瘤的MG患者的病情严重程度及Tx术后2个月的临床疗效；采用直接免疫荧光染色和流式细胞仪技术测定60名志愿健康者和30例伴胸腺增生或胸腺瘤的MG患者Tx术前及术后2个月T淋巴细胞亚型的变化。结果：伴胸腺增生或胸腺瘤的MG病人Tx术前外周血中CD4＋T淋巴细胞的百分率较正常人显著增多(P＜0．01)，CD8＋T淋巴细胞的百分率较正常人显著减少(P＜0．01)，CD4＋/CD8＋T细胞的比例明显增高(P＜0．01)。伴胸腺增生MG病人Tx术后随着临床症状的改善，CD8＋T淋巴细胞的百分率较术前显著升高(P＜0．05)，CD4＋/CD8＋T细胞的比例较术前显著下降(P＜0．05)。伴胸腺瘤MG病人Tx术后随着临床症状的改善，CD4+T淋巴细胞的百分率较术前显著下降(P＜0．05)，CD4＋/CD8＋T细胞的比例较术前显著下降(P＜0．05)。结论：重症肌无力患者T淋巴细胞亚型的测定既可以为MG免疫病理学的发病机理的研究提供实验依据，也能为Tx治疗MG提供一个客观的实验室指标，为判断疾病的转归提供实验依据。
Objective： To study the abnormalities of cellular immunity of myasthenia gravis（MG） and the effects of thymectomy （Tx）on lymphocyte subsets in patients with MG. Methods： Phenotypic analysis of peripheral blood lymphocyte in 30 patients with MG .and 30 controls were completed using flow cytometry and immunofluorescence staining methods; changes of lymphocyte subsets were studied in 30 MG patients after Tx therapy. Results： The percentage of CD8＋ T cells decreased significantly（P〈0.01） and that of CD4＋ T cells and CD4＋/CD8＋ ratio increased significantly （P〈0. 01）as compared with normal controls before Tx. The percentage of CD8＋ T cells increased significantly（P〈0.05） and CD4＋/CD8＋ ratio decreased significantly（P〈0.05） in MG patients with thymic hyperplasia after Tx. The percentage of CD4＋ T cells and CD4＋/CD8＋ ratio decreased significantly（P〈0.05） in MG patients with thymoma after Tx. Conelusions： there were abnormalities of cellular immunity in MG patients with thymic hyperplasia or thymoma. There were significant changes of the T cells subsets in patients with MG after Tx. The results indicated that. phenotypic analysis of peripheral blood lymphocyte was valuable in providing immunological parameters of therapeutic evaluation in MG and further demonstrated immunological pathogenesis of MG.
出处
《脑与神经疾病杂志》
2005年第5期321-324,共4页
Journal of Brain and Nervous Diseases
基金
天津市社会发展科技计划资助项目(编号为033111411)
