重症肌无力危象患者血清titin抗体检测的临床意义

Clinical significance of serum Titin antibody measurement in patients with Myasthenia gravis crisis

目的探讨重症肌无力（MG）危象患者血清titin抗体检测的临床意义。方法选择自2008年7月至2010年8月在解放军第309医院MG治疗中心就诊且确诊的MG危象患者26例为MG危象组，同期该院其他神经系统疾病（OND）患者30例为OND组，同期该院健康体检者30例为对照组。应用酶联免疫吸附法（ELISA）检测3组成员血清titin抗体水平，观察titin抗体与MG危象患者临床特征及预后转归的关系。结果MG危象组、OND组titin抗体阳性率分别为73．1％、3．3％，健康对照者titin抗体为阴性，差异有统计学意义萨51．922，P=0．000）；50岁以上（含50岁）MG危象患者titin抗体阳性率明显高于50岁以下患者，差异有统计学意义（x2=5．052，P=-0．014）；不同性别、Osserman分型及胸腺病理类型患者titin抗体阳性率差异无统计学意义（p＞0．05）。治疗后titin抗体滴度下降，与治疗前比较差异有统计学意义（P〈0．05）。结论MG危象患者血清titin抗体阳性率偏高，且与患者病情严重程度有关，对于判断MG危象患者的临床转归有一定的参考价值。

Objective To measure the clinical significance of serum Titin antibody measurement in patients with myasthenia gravis （MG） crisis. Methods Twenty six patients with MG crisis, 30 patients with other neurologieal diseases （ONDs） and 30 health controls, collected in our hospital from July 2008 to August 2010, were chosen in our study; the sera level oftitin antibody was dectected by enzyme-linked immunosorbentassay （ELISA）; correlations of titin antibody level with the clinical features and prognosis of the patients with MG crisis were analyzed. Results The positive rate of titin antibodies in MG crisis group and ONDs group was 73.1% and 3.3%, and it was negative in health control group; significant differece was noted （Xz=51.922 ,P=0.000）. The positive rate of titin antibodies in patients older than 50 years of the MG crisis group was signifcantly higher than that in patients younger than 50 years （Vz=5.052, P=0.014）; the positive rate of titin antibodies in MG crisis group was negatively correlated to the gender of the patients, the types of Osserman and the pathological types （P〉0.05）. The titin antibody titer after treatment was significantly decreased as compared with that before treatment （P〈0.05）. Conclusion Positive titin antibody is mostly found in MG crisis and it＇s level is related to the severity of MG crisis, indicating that it might be beneficial for evaluating prognosis of MG patients.