重症肌无力患者的免疫指标与临床疗效分析

Analysis of Immune Indexes and Clinical Efficacy in Patients with Myasthenia Gravis

目的：探讨并分析重症肌无力（MG）患者的免疫指标和临床治疗效果。方法：选取我院2010年6月~2014年6月接收的200例重症肌无力患者,在治疗前和治疗后采用细胞仪检测外周血CD3、CD4和CD8及采用比浊法检测IgG、IgA和IgM,进行分类比较其变化。结果：全身型重症肌无力患者的IgG、IgA较眼肌型高（P〈0.05）,差异具有统计学意义。在治疗前后的免疫指标（CD3、CD4、CD8、IgG、IgA及IgM）和临床资料（男/女、眼肌型/全身型、检测时病程、检测时年龄）的对比中,差异无统计学意义（P〉0.05）。在体液免疫低下组中,用丙种球蛋白治疗的缓解率比未用丙种球蛋白组的缓解率高（P〈0.01）,差异具有统计学意义。结论：重症肌无力患者免疫指标IgG、IgA、IgM、CD3、CD4、CD8虽然不能作为重症肌无力患者的病情和疗效的唯一评价指标,但对指导治疗具有一定的参考价值,且体液免疫低下者用丙球蛋白的疗效较好。

Objective： To investigate and analyze the immune index and clinical therapeutic effect of myasthenia gravis（MG） patients. Methods： 200 cases of patients with myasthenia gravis were selected, and the level of CD3, CD4 and CD8 was detected by FCM and the change of IgG, IgA and IgM was observed by immunoturbidimetry on the classification. Results： The level of IgG and IgA in the patients with myasthenia gravis were high（P〈0.05） in systemic onset, the difference was statistically significant. There was no significant difference in the immune parameters（CD3, CD4, CD8, IgG, IgA and IgM）and clinical data（male/female, ocular type / systemic onset,disease course at detecting and age at detecting） before and after treatment（P〉0.05）. In humoral immunity group, the remission rate in the patients treated with gamma globulin was higher than that of the patients unused gamma globulin protein group（P〈0.01）, the difference was statistically significant. Before and after treatment, there was no significant difference between the immune indexes and clinical data.Conclusions： The immune indexes of IgG, IgA, IgM, CD3, CD4, CD8 have certain reference value for treatment of myasthenia gravis although they can’t be considered as only indexes for the severity and curative effect of this disease, and the patients with low humoral immunity has great clinical efficacy with γ-globulin.