免疫球蛋白对重症肌无力患者临床症状及免疫功能的影响

Effects of immunoglobulins on clinical symptoms and immune function in patients with myasthenia gravis

目的探究免疫球蛋白对重症肌无力(MG)患者临床症状及免疫功能的影响。方法选取2018年6月至2020年6月河南科技大学第一附属医院收治的136例MG患者作为研究对象,采用随机数表法将患者分为对照组(糖皮质激素冲击治疗,n=68)和试验组(免疫球蛋白注射治疗联合糖皮质激素冲击治疗,n=68),比较两组患者临床症状、免疫功能以及不良反应情况。结果试验组有效率为95.59%(65/68)显著高于对照组85.29%(58/68)(P<0.05);治疗前,两组患者T淋巴细胞亚群水平与血清可溶性白细胞介素-6受体(sIL-6R)水平差异无统计学意义(P>0.05);治疗后,两组患者T淋巴细胞亚群水平与血清sIL-6R水平均有下降,试验组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)与sIL-6R水平显著低于对照组(P<0.05);两组患者不良反应发生情况(4.41%vs.2.94%)差异无统计学意义(P>0.05)。结论采用免疫球蛋白治疗重症肌无力患者,可显著改善患者临床症状、缓解患者病情,患者免疫功能也得到一定程度改善。

【Objective】To explore the effects of immunoglobulins on clinical symptoms and immune function in patients with myasthenia gravis(MG).【Methods】A total of 136 patients with MG admitted to the First Affiliated Hospital of Henan University of Science and Technology from June 2018 to June 2020 were selected,and divided into control group(glucocorticoid for shock therapy,n=68)and experimental group(immunoglobulins injection combined with glucocorticoid for shock therapy,n=68)by random number table method.The clinical symptoms,immune function and adverse reactions between the two groups were compared.【Results】The response rate of experimental group was significantly higher than that of control group[95.59%(65/68)vs.85.29%(58/68)](P<0.05).Before treatment,there was no significant difference in levels of T lymphocyte subsets and serum soluble interleukin-6 receptor(sIL-6 R)between the two groups(P>0.05),which were deceased in both groups after treatment.The levels of CD 3^(+),CD 4^(+),CD 4^(+)/CD 8^(+)and sIL-6 R in experimental group were significantly lower than those in control group(P<0.05).The difference in incidence of adverse reactions between the two groups was not statistically significant(4.41%vs.2.94%)(P>0.05).【Conclusion】The application of immunoglobulins can significantly improve clinical symptoms and alleviate conditions of MG patients,with certain improvement of immune function.