甲亢对重症肌无力患者免疫抗体水平的影响

Effects of Hyperthyroidism on the Immune Antibody Levels in Patients with Myasthenia Gravis

【目的】探讨甲状腺功能亢进（甲亢）对重症肌无力（MG）患者免疫抗体水平的影响。【方法】252例MG患者根据其是否合并甲亢分成甲亢组（n=31）和非甲亢组（n=221）两组。比较两组患者血清游离甲状腺素（FT4）、游离三碘甲状腺原氨酸（FT3）、促甲状腺素（TSH）等甲状腺功能指标差异及甲状腺抗体阳性率，分析两组血清免疫球蛋白G（IgG）、IgA、IgM等免疫球蛋白水平差异。【结果】①两组患者血清TSH水平均显著低于正常值范围，血清FT4、FT3水平则显著高于正常值范围，且差异具有显著性（P〈0．05）；其中甲亢组血清TSH水平明显低于非甲亢组，血清FT4、FT3水平则明显高于非甲亢组，且两组相比较差异具有显著性（P〈0．05）；②甲亢组甲状腺抗体阳性率为93．55％（29／31），显著高于非甲亢组的66．97％（148／221，P〈0．05）；③两组患者血清IgA、IgM水平相比较差异无显著性（P〉0．05）；甲亢组血清IgG水平显著高于非甲亢组，且差异有显著性（P〈0．05）。【结论]MG合并甲亢可影响MG患者的免疫抗体水平，促进病情发展，需引起临床重视。

[Objective]To investigate the effects of hyperthyroidism on the immune antibody levels in pa- tients with myasthenia gravis （MG）. [Methods]The 252 cases of MG patients were selected as the study sub- jects. Given that all patients were complicated with hyperthyroidism, they were further divided into the hyper- thyroidism group （ n = 31） and the non-hyperthyroidism group （ n = 221）. The differences in serum free thy- roxine （FT4）, free three triiodothyronine （FT3）, thyroid ttimulating hormone （TSH）, and other thyroid function indexes between the two groups were recorded. The positive rate of thyroid antibody, serum immuno- globulin G （IgG） levels, serum immunoglobulin A （IgA） levels, serum immunoglobulin M 4IgM） levels, and other immunoglobutin levels were recorded and compared between the two groups. [Results]（1） The serum TSH levels in the two groups were both significantly lower than the normal range while serum FT4 and FT3 levels were significantly higher than the normal range （ P 〈0.05）. The serum TSH levels in hyperthyroidism group were significantly lower than those in the non-hyperthyroidism group while serum FT4 and FTa levels were higher than those in the non-hyperthyroidism group （ P 〈0.05）. QThe positive rate of thyroid antibody in the hyperthyroidism group was 93.55 %, and was significantly higher than in the non-hyperthyroidism group （66.97 % ） （P 〈0.05）. （3）There was no statistical significance in the comparison of serum IgA and IgM levels between the two groups （ P 〉0.05）. The serum IgG levels in the hyperthyroidism group were significantly higher than those in the non-hyperthyroidism hyperthyroidism group （ P 〈0.05）. [Conclusion] Being compli- cated with hyperthyroidism can affect the immune antibody levels in MG patients and promote the development of the disease, and calls for greater clinical attention.