重症肌无力患者外周血Th17和调节性T细胞分析

Analysis of circulating Th17 cells and regulatory T cells in myasthenia gravis

目的 观察重症肌无力（myasthenia gravis,MG）患者Th17细胞和调节性T细胞的水平,并研究甲强龙冲击治疗对其影响.方法 应用四色流式细胞仪检测66例MG患者及35名健康对照者外周血Th17细胞和CD4^＋CD25^highT细胞百分率;分析其中18例患者外周血Th17细胞与美国MG协会（MGFA）评分相关性;观察8例MG患者甲强龙冲击治疗2周后上述细胞的变化.结果 MG患者与健康对照者外周血Th17细胞百分率分别为2.61%±0.28%与0.94%±0.12%（Z=4.059,P=0.0001）;甲强龙治疗前后8例MG患者Th17细胞百分率分别为4.72%±1.21%与1.81%±0.69%,差异有统计学意义（Z=1.995,P=0.0460）;患者外周血Th17细胞水平与MGFA评分呈正相关（r=0.5359,P=0.0219）.结论 MG患者外周血中Th17细胞升高,甲强龙冲击治疗可降低其水平,这可能是改善MG患者病情的有效机制.

Objective To investigate the percentage of Th17 cells and regulatory T cells in patients with myasthenia gravis （MG） and observe the effects of methylprednisolone infusion on these cells.Methods The circulating Th17 cells and CD4^＋ CD25^highT cells of 66 MG patients and 35 healthy controls were detected using four colour cytometry. The relationship between these cells and MGFA score in 18 MG patients and in 8 MG patients after methylprednisolone was infusion were also analyzed in this study. Results There was significant difference in the percentage of circulating Th17 cells between MG patients （2. 61% ±0. 28% ） and the healthy controls （0. 94% ± 0. 12%, Z = 4. 059, P = 0. 0001 ）. Methylprednisolone therapy significantly reduced the percentage of circulating Th17 cells from 4. 72% ± 1.21% to 1.81% ± 0. 69%（Z = 1. 995,P = 0. 0460）. In addition, the percentage of Th17 cells showed a positive correlation with MGFA score（r =0. 5359, P =0. 0219）. Conclusions Circulating Th17 cells are elevated in MG patients.Methylprednisolone therapy can reduce such elevation, and this may be important in mediating symptomatic improvement in MG patients.