血清乙酰胆碱受体抗体、肌肉特异性酪氨酸激酶抗体浓度与重症肌无力患者临床分型和疾病转归的关系

The relationship between serum acetylcholine receptor antibody,muscle specific tyrosine kinase antibody concentration and clinical classification and prognosis in patients with myasthenia gravis

目的探索血清乙酰胆碱受体抗体(AchR-Ab)、肌肉特异性酪氨酸激酶抗体(MuSK-Ab)浓度与重症肌无力(MG)患者临床分型和疾病转归的关系。方法收集2014年5月-2015年5月在本院神经内科住院治疗的MG患者43例(MG组)和同期在本院健康体检的正常人43例(N组),采用酶联免疫吸附(ELISA)法检测血清AChR-Ab、MuSK-Ab浓度,并计算MG组患者治疗前后的肌无力绝对评分,分析不同临床分型的MG患者治疗前的血清AChR-Ab、MuSK-Ab浓度,并对治疗前后肌无力绝对评分和治疗前后血清AChR-Ab、MuSK-Ab浓度变化进行相关性分析。结果 (1)治疗前,MG组和N组的血清AChR-Ab浓度分别为0.786±0.237ng·mL^(-1)、0.298±0.113ng·mL^(-1),差异有统计学意义(均P<0.05),血清Mu SK-Ab浓度分别为0.322±0.128ng·mL^(-1)、0.281±0.123ng·mL^(-1),差异无统计学意义(均P>0.05);(2)血清AChR-Ab和MuSK-Ab在不同临床分型MG患者中的浓度均没有明显差异(均P>0.05);(3)治疗后肌力绝对评分和血清AChR-Ab浓度均显著下降(均P<0.05),而血清MuSK-Ab浓度在治疗前后没有显著变化(P>0.05),并且治疗后的血清AChR-Ab浓度和治疗后的肌无力绝对评分呈正相关(r=0.797,P<0.05)。结论血清AChR-Ab和MuSK-Ab的浓度与MG的临床分型无明显相关性,血清AChR-Ab对疾病的转归有一定的预示作用。

Objective To explore the relationship between serum acetylcholine receptor antibody(AChRAb),muscle specific tyrosine kinase antibody(MuSK-Ab)concentration and clinical classification and prognosis of patients with myasthenia gravis(MG).Method Selected forty-three patients(MG group)in Department of Neurology our hospital from May 2014 to May 2015 and forty-three cases(N group)of normal subjects in our hospital during the same period.AChR-Ab and MuSK-Ab concentration were detected by using enzyme-linked immunosorbent assay(ELISA),the myasthenia clinical absolute scores before and after treatment in MG group were calculated,andanalysed the serum AChR-Ab and MuSK-Ab concentration of the different clinical classification MG patients after the treatment.The correlation between the myasthenia clinical absolute scores and the change of serum AChR-Ab and MuSK-Ab concentration were analyzed.Results①Before the treatment,theAChR-Ab concentration of the MG group and N group were 0.786±0.237ng·mL-1,0.298±0.113ng·mL-1 respectively,which were significantly different(P<0.05),the MuSK-Ab concentration were 0.322±0.128ng·mL-1,0.281±0.123ng·mL-1 respectively,which were not statistically significant(P>0.05);②The serum AChR-Ab and MuSK-Ab concentration of the different clinical classification MG patients were significantly decreased(all P>0.05);③After treatment,the myasthenia clinical absolute scores and the serum AChR-Ab concentration were significantly decreased(P<0.05),the serum MuSK-Ab concentration were not significantly different before and after treatment(P>0.05),the AChRAb concentration and the myasthenia clinical absolute scores after treatment was positive correlation(r=0.797,P<0.05).Conclusion The serum AChR-Ab and MuSK-Ab concentration were not significantly correlated with the clinical classification of MG,and serum AChR-Ab had a certain predictive effect on the prognosis of the disease.