重症肌无力病人血清中IgM型乙酰胆碱受体、突触前膜抗体检测及临床意义

Detection of IgMAcetylcholine Receptor and Presynaptic membrane Antibodies in serum and its clinical significance from patients with Myasthenia Gravis

应用ＡＢＣ－ＥＬＩＳＡ法检测了９６例重症肌无力（ＭＧ）病人血清中ＩｇＭ－ＡｃｈＲ、Ｐｓｍａｂ。发现ＭＧ组中，有１８例（１８．７％）ＩｇＭ－ＡｃｈＲａｂ阳性；１０例（１０．４％）ＩｇＭ－Ｐｓｍａｂ阳性。ＩｇＭ－Ｐｓｍａｂ阳性频见于病程＜２年的ＭＧ病人；而与ＭＧ组病人的年龄和临床分型均无显著的相关性（Ｐ＞０．０５）。结果提示ＩｇＭ型抗体也与ＩｇＧ型抗体共同参与了ＭＧ的发病机制，且提示有神经肌肉接头突触前膜的体液免疫学异常。

IgM antibodies to AchR and Presynaptic membrane protein(Psm)was detected by ELISA in sera from 96 patients with myasthenia gravis(MG). In MG group, IgM AchRab and Psmab were positive in 18(18.7%)and 10 (10.4%)cases respectively.The level of IgM-Psmab in the group of MG duration less than 2 years was very significantly higher than that of more than or equal to 2 years, but no significant difference between IgMPsmRab and ages,clinical classification(P>0.05). The result suggested that IgM antibodies participate the pathogenesis of MG with IgG antibodies; and showed that the damage is included in humoral immunologic abnormality of the presynaptic membrane on NMJ.