重症肌无力患者血清TNF水平变化及其与AChRab产生的相关性研究

ThestudyonvariationofserumTNFlevelanditscorrelationwithAchRabinmyastheniagravispa┐tients

为了探讨肿瘤坏死因子（ＴＮＦ）在重症肌无力（ＭＧ）发病机理中的作用及其临床意义以及受糖皮质激素（ＧＣ）治疗的影响，应用ＭＴＴ法检测了４２例ＭＧ患者血清ＴＮＦ水平，同时检测了其中３６例ＭＧ患者血清乙酰胆碱受体抗体（ＡＣｈＲａｂ），并观察了２０例ＭＧ患者ＧＣ治疗前后ＴＮＦ水平及ＡＣｈＲａｂ的变化。结果显示：眼肌型、全身型ＭＧ患者血清ＴＮＦ水平皆明显高于正常对照组，ＴＮＦ水平变化与ＡＣｈＲａｂ产生以及与ＭＧ临床类型、病情密切相关，ＧＣ治疗后血清ＴＮＦ水平及ＡＣｈＲａｂ阳性率明显降低。我们认为ＴＮＦ在ＭＧ发病机理上发挥了重要作用，检测血清ＴＮＦ水平对指导ＭＧ临床有重要价值。

Inordertounderstandtheroleoftumornecrosisfactor(TNF)inthepathogeneticmechanismofmyastheniagravis(MG),theclinicalvalueofTNFfortheMGpatientsandtheefectofglucocorticosteroids(GC)onTNFproductioninMGpatients.TheserumTNFlevelwereexam-inedin42MGpatientsand40normalcortrols(NC)withMTTassayaswelastheserumacetyl-cholinereceptorantibodies(AChRab)weredynamicalymeasuredin36MGpatients,measuredagainin20MGpatientsafterusingGC.TheserumTNFlevelofgeneralizedandbulbarMGpatientsweremuchhigherthanthatofNC.ThevariationofserumTNFlevelwererelatedtonotonlytheAChRabproductionbutalsotheclinicaltypesandthediseaseseverityofMG.TheserumTNFlevelandAChRabpositiverateweresignificantlyloweredafterusingGC.ItwasconsiderthatTNFplsysanimportantroleinthepathogeneticmechanisminthedevelopmentofMG.ThedeterminationofTNFwouldbeusefulinsuggestingtheclinicalmanagementofMG.GCcanhelpinhibittheproductionofTNFandAChRabinpatientswithMG.