全血灌流吸附治疗重症肌无力的实验研究

Treatment of myasthenia gravis with systemic hemoperfusion adsorption

目的 观察全血灌流免疫吸附治疗重症肌无力的疗效。方法 以电鳗乙酰胆碱受体α亚单位Ta183 2 0 0段多肽为免疫源建立实验性自身免疫性重症肌无力动物模型 ,用以纤维素为载体、色氨酸为配基的吸附剂IM MG对实验兔进行全血灌流吸附治疗 ,比较治疗前后临床症状、抗体滴度、神经电生理功能的变化。结果 IM MG灌流治疗 2h ,能清除 (4 8 5 4± 2 4 7) %的致病抗体 ,肌无力症状显著改善 ;3、 5、10Hz重复神经电刺激实验复合动作电位衰减率明显恢复 (P <0 0 5 ) ,从治疗前的 (2 1 88± 7 2 4 ) %、(2 3 88± 7 4 2 ) %和 (2 5 75± 5 97) %依次恢复到 (16 0 0± 6 78) %、 (16 88± 7 4 2 ) %和 (17 5 0± 7 5 8) %。结论 IM MG全血灌流吸附治疗能有效清除重症肌无力动物体内的致病抗体 ,并相应改善肌无力症状 ,提高神经肌肉电传导功能 。

Objective To investigate the effects of systemic hemoperfusion adsorption in the treatment of myasthenia gravis.Methods Myasthenia gravis (MG)models in rabbits were produced by immunization with Tal83-200 and treated with systemic hemoperfusion.The clinical improvement was evaluated through clinical score,antibody titers,and changes in neuroelectrophysiological function.Results The pathogenic antibodies of Tal83-200 were removed by(48.54±2.47)% at 2 h after treatment.The attenuation percentage of compound muscle action potential at 3,5,10Hz in MG rabbits decreased from(21.88±7.24)%,(23.88±7.42)% and (25.75±5.97)% to (16.00±6.78)%,(16.88±7.42)% and (17.50±7.58)%,respectively.Conclusion Systemic hemoperfusion adsorption could remove pathogenic antibodies in MG effectively,and improve clinical manifestation and neuromuscular function.It may be considerated in the future for treating myasthenic crisis.