重症肌无力患者血清胱抑素C水平与临床特征的相关性研究

The correlation between serum cystatin C levels and clinical characteristics in patients with myasthenia gravis

目的胱抑素C(Cystain C,Cys C)是半胱氨酸蛋白酶(cathepsins,Cat)的抑制剂,在生物体调节先天免疫细胞吞噬、主要组织相容性复合体-II介导的抗原表达及凋亡等过程中扮演重要角色。本文旨在观察探讨急性期重症肌无力(myasthenia gravis,MG)患者血清Cys C的水平变化及其与临床特征的关系。方法选择2018年6月至2019年8月就诊于我院的MG患者70例及健康对照组42例,收集各组患者临床资料,包括性别、年龄、空腹血清Cys C、肌酐、肾小球滤过率、MG组患者胸腺增强CT和血清乙酰胆碱受体(acetylcholine receptors,AChR)抗体滴度,采用Osserman分型方法为MG患者分型,采用定量重症肌无力(Quantitative myasthenia gravis,QMG)评分评价MG患者临床症状的严重程度。比较MG患者和对照组血清Cys C水平的差异和MG患者血清Cys C水平与QMG评分、Osserman分型、AChR抗体滴度之间的相关性。结果3组间统计学结果有显著差异,未合并胸腺瘤MG组和合并胸腺瘤MG组血清Cys C水平均显著高于对照组[(0.900±0.238,0.998±0.235,0.776±0.123)mg/L,P=0.000]。血清Cys C水平与临床QMG评分呈正相关关系(r=0.482,P<0.0001),但与胸腺瘤、Osserman分型、AChR抗体滴度无明显相关(P>0.05)。结论MG患者血清Cys C水平明显升高,Cys C可能参与MG疾病的发生发展。

Objective Cystain C(Cys C)is an inhibitor of cysteine proteases(cathepsins,Cat),and has a wide range of biological effects in vivo.The aim of this study was to investigate the changes in serum Cys C levels in patients with acute myasthenia gravis(MG)and its relationship with clinical characteristics.Method We selected 70 MG patients and 42 healthy control patients who were admitted to the first affiliated hospital of Zhengzhou University from June 2018 to August 2019,MG patients were divided into two groups according to whether they were complicated with thymoma or not.Retrospectively analyzed clinical data of patients in each group,including Collect clinical data of patients in each group,including age,gender,fasting serum creatinine,Cys C,glomerular filtration rate(GFR)and acetylcholine receptor(AChR)antibody concentration.MG patients were divided into ocular group and generalized group by Osserman typing evaluated the severity of MG patients by Quantitative myasthenia gravis(QMG)score.The correlation of serum cystatin C level with clinical classification,severity of disease,thymoma and AChR antibody in MG patients was analyzed.Results Serum Cys C levels in both the MG group without thymoma and the MG group with thymoma were significantly higher than those in the control group[(0.900±0.238,0.998±0.235,0.776±0.123)mg/L,P=0.000],serum Cys C level was positively correlated with QMG score(r=0.482,P<0.0001),but was not significantly correlated with clinical classification and AChR antibody titer(P>0.05).Conclusion Serum Cys C levels in MG patients were significantly increased,Cys C may be involved in the development of MG.