糖皮质激素治疗对重症肌无力患者补体的影响

Glucocorticoid Therapia affect the Concentration of Complement in Sera of Myasthenia Gravis Patients

目的检测糖皮质激素治疗重症肌无力(MG)患者血清补体水平的变化,以探讨其和糖皮质激素治疗间的关系。方法对MG患者进行糖皮质激素规范化治疗,检测患者治疗前后血清补体水平,并计算其治疗前后补体水平的差值,分析患者补体水平变化和糖皮质激素之间的关系。结果(1)治疗前糖皮质激素治疗组(GMG)和非糖皮质激素治疗组(NGMG)C3水平差异无统计学意义(P>0.05),两组均较非MG患者对照组(NC)明显降低(P<0.01);治疗后GMG组和NGMG组C3水平增高但仍低于NC组(P<0.01),同组治疗前后比较,结果GMG组治疗后浓度增高明显(P<0.05),而NGMG组和NC组(P>0.05)浓度改变无统计学意义。(2)治疗前后3组C5水平变化不明显(P>0.05)。结论糖皮质激素可使MG患者血清C3浓度增高,对C5浓度影响不明显。

Objective To investigate the effect of glucocortieoid therapy on the sera concentration of complement in MG patients. Methods Twenty-two MG patients were treated with glueoeortieoid. Concentrations of C3 and C5 of MG patients sera was measured and variation was calculated prior-treatment and post-treatment. Then the relationship of the variation of complement concentration to glueoeortieoid treatment was statistically analysised. Results （1） Prior-treatment, the difference of C3 concentration between group MG patients treated with glueoeortieoid （GMG group） and group MG patients treated without glueoeortieoid （NGMG group） was not significantly different （P〉0. 05）, the concentrations of C3 in group GMG and group NGMG were lower than that of control group （NC group） （P〈0.01）; Post-treatment, concentration of C3 was increased in group GMG and group NGMG, but they were still lower than that of group NC, the difference of concentration between group NGMG and group NC was not significant （P 〉 0. 05 ）. The variation of concentration pre-treatment and post-treatment was significant （P=0. 028） in group GMG in statistical analysis, but the variation was not significant in group NGMG （P〉0.05） and group NC （P〉0.05）. （2） The concentration of C5 among 3 groups were not different significantly pre- and post-treatment. The variation of concentration pre-treatment and post-treatment among the 3 groups was not significant （P〉0. 05） in statistical analysis either. Conclusions The concentration of C3 in MG patients sera was increased by glucocorticoid therapy, the changes of C5 concentration prior-treatment and post-treatment was not significant.