重症肌无力患者AchR-Ab、Titin-Ab的检测及其临床意义

Detection and Significance of Achr-Ab and Titin-Ab in Diagnosis of Myasthenia Gravis

目的对重症肌无力患者血清乙酰胆碱受体抗体(AchR-Ab)、连接素抗体(Titin-Ab)进行检测,探讨其临床意义,为临床提供诊断、治疗的依据。方法选取本院2013年1月至2014年12月收治的重症肌无力患者80例。依据胸部CT检查结果将患者分为伴胸腺瘤(MGT)组与不伴胸腺瘤(NTMG)组。测定各组患者外周血AchR-Ab与Titin-Ab的含量并统计阳性例数,探讨其用于诊断重症肌无力的价值及意义。结果 MG组AchR-Ab与Titin-Ab阳性率明显高于HC组,MGT组AchR-Ab与Titin-Ab阳性率明显高于NTMG组,全身型(Ⅱ~Ⅳ型)AchR-Ab与Titin-Ab阳性率明显高于眼睑型(Ⅰ型)组,差异具有统计学意义(P<0.05)。结论 AChR抗体作为临床使用最广泛的重症肌无力患者检测指标具有一定价值,Titin抗体是应用于重症肌无力患者合并胸腺瘤时敏感而特异的血清学指标,在重症肌无力患者中开展血清Titin抗体的测定对于胸腺瘤的诊断及判断预后具有重要的临床指导意义。

Objective To explore the clinical significance of Titin-Ab and AchR-Ab in diagnosis of myasthenia gravis,and to provide the basis for clinical diagnosis and treatment. Methods A total of 80 cases of myasthenia gravis patients admitted in our hospital from January 2013 to December 2014 were selected.According to the CT examination of the chest,patients were divided into myasthenia gravis with thymoma group（ M GT） and myasthenia gravis without thymoma group（ NTM G）. AchR-Ab and Titin-Ab in each group were measured and the number of positive cases were counted. The value and significance of AchR-Ab and Titin-Ab were explored in the diagnosis of myasthenia gravis. Results The positive rates of AchR-Ab and Titin-Ab were significantly higher in M G than in HC. The positive rates of AchR-Ab and Titin-Ab were significantly higher in group M GT than in group NTM G,the positive rates of AchR-Ab and Titin-Ab were significantly higher in group Body type（ II ~ IV） than in group eyelid type（ type I）. Conclusion AChR antibody and Titin antibody might be sensitive and specific serological indicators in myasthenia gravis patients with thymoma. Detection of both antibodies might have animportant clinical significance for thymoma diagnosis and prognosis in myasthenia gravis patients.