重症肌无力患者外周血T细胞亚群变化及其临床意义

Changes of T cell subsets in peripheral blood of myasthenia gravia patients and clinic significance

目的探究重症肌无力(myasthenia gravia,MG)患者外周血T细胞亚群比例变化特点及其临床意义。方法选取新乐市医院检验科确诊MG患者35例作为试验组(MG组),选取同期健康者32例作对照,按照Osserman分类标准,MG患者又被分为全身型MG(generalized myasthenia gravis,GMG)22例(62.9%),眼肌型MG(ocular myasthenia gravis,OMG)13例(37.1%)。采用流式细胞技术测定健康对照组与MG组外周血T细胞中CD4+、CD8+细胞亚群,研究其不同年龄、病程、临床分型的变化特点和临床治疗的相关性。结果 MG组中CD4+T细胞亚群较对照组明显升高(43.34±14.11)%vs(36.35±12.17)%(P<0.05),而CD8+T细胞亚群较对照组有明显下降(26.76±4.23)%vs(35.89±7.66)%(P<0.05),与对照组比较,GM组CD4+/CD8+细胞亚群比例明显增高(P<0.05),且随着年龄增加,比值升高越明显(P<0.05);眼肌型MG患者与全身型MG比较,其CD4+、CD8+分布差异无统计学意义(P>0.05);病程越长(病程≥3年),其CD8+越低,CD4+/CD8+比例越高(P<0.05)。结论MG患者外周血T细胞亚群分布异常,并且随着年龄的增大、病程的加长愈发明显,但其与临床分型基本无关。T细胞亚群的分布比例与MG的疾病情况关系很大,检测T细胞亚群比例对临床治疗MG有重要意义。

Objective To explore the changes of T cell subset proportions in the peripheral blood of patients with myasthenia gravia（MG） and its clinic significance. Methods Thirty-five MG patients （MG group） from Clinical Laboratory of Xinle Hospital were selected. According to Osserman classification criteria, MG patients were divided into generalized myasthenia gravis（GMG） 22 cases （62.9%） and ocular myasthenia gravis（OMG） 13 cases （37. l %）. The expression levels of CD4＋ and CD8＋ in peripheral blood in 35 MG patients （MG group） and 32 healthy volunteers （control group） were analyzed by flow cytometry. Age, disease duration, the clinical classification and the relationship with the treatment were investigated. Results Compared with that of control group, the percentage of CD4＋ in MG group was significantly elevated （43.34±14.11）% vs （36.35± 12.17）0/6o （ P do. 05） and the percentage of CD8＋ in MG group was significantly decreased （26.76±4.23）% vs （35.89±7.66）%（ P 〈0.05）. The ratio of CD4＋/CD8＋ in GM group was significantly increased compared with that of control group. The percentage of CD4＋ and CD8± of ocular MG patients and generalized MG patients were not significantly different （ P 〉0.05）. The longer the disease duration, the lower the CD8＋ percentage,and the higher the ratio of CD4＋/CD8＋ （ P 〈0.05）. Conclusion The T cell subsets in MG patients were abnormally distributed,and they were much more apparent with increasing age and disease duration. But,there were no relationship between the proportion of T cell subsets and the clinical classification. Detection of the proportion of T cell subsets in the peripheral blood has clinical significance for the treatment of MG.