重症肌无力血清抗乙酰胆碱受体抗体和抗突触前膜抗体监测的临床意义

The clinical significance or monitoringacetylcholine receptor antibody and presynap-tic membranae antibody in myasthenia gravis

用ＡＢＣ－ＥＬＩＳＡ法对５０例重症肌无力（ＭＧ）病人血清中抗乙酰胆碱受体抗体（ＡｃｈＲａｂ）和抗突触前膜抗体（ＰｒＭａｂ）进行检测。结果发现：①ＭＧ患者抗体总阳性３７例（阳性率７４％），其中ＡｃｈＲａｂ阳性３３例（６６％），ＰｒＭａｂ２９例（５８％），二者均显示重症患者阳性率高于轻症。②血清中两种抗体滴度重症患者均明显高于轻症，胸腺肿瘤ＡｃｈＲａｂ滴度明显高于胸腺增生病例，抗体滴度与胸腺病理关系呈肿瘤＞萎缩或正常＞增生。③ＡｃｈＲａｂ和ＰｒＭａｂ高度相关。结果表明ＡｃｈＲａｂ与ＭＧ病情轻重和胸腺病理有一定关系，可用于ＭＧ的病情监测，ＰｒＭａｂ同样可以作为ＭＧ的一项免疫学诊断指标，有重要的临床应用价值。

The acetylcholine receptor antibody(AchR ab ) and presynaptic membrane anti-body(PrM ab ) in sera were measured from 50cases with myasthenia gravis(MG)by usingthe method of ABC-ELISA. the result showed that(1) AchR ab were positive in 33 cases(66%)of MG patient,PrM ab positive in 29cases(58%),with the total(both or one ofthem ) positive rate of 74%(37 cases). Thepositive rate in severe cases was higher thanthat in mild cases;(2)the antibody level insera was much higher in severe cases than inmild cases and the AchR ab level in thymomawas higher than that of hyperplasia.The anti-body levels related to thymus physiologyshowed an order of thymoma>atrophy ornormal > hyperplasia.(3)A great relevancewas found between AchR ab and PrM ab. It is suggested that AchR ab bear some relationwith the severity of MG and thymus physiolo-gy and that it could be used in monitoringMG. PrM ab is also valuable as an diagnosticindex for immunity.