重症肌无力治疗后CD+4CD+25Tr细胞的临床研究.docVIP

重症肌无力治疗后CD+4CD+25Tr细胞的临床研究 　　作者：乞国艳 郑旭光 杨红 郄春菊 张太明 刘慈 顾姗姗 作者单位：050011 河北省石家庄市第一医院肿瘤科(乞国艳、杨红、郄春菊、刘慈、顾姗姗)，心胸外科(郑旭光、张太明) 　　【摘要】 目的 研究重症肌无力患者胸腺切除术后应用免疫抑制剂的治疗效果。方法 A组：50例重症肌无力患者胸腺切除术后应用免疫抑制剂组;B组：50例重症肌无力患者未行胸腺切除直接应用免疫抑制剂组;用流式细胞仪计数外周血A、B组治疗前和治疗后6、12个月的CD+4CD+25Tr细胞的百分率，应用许氏临床评分法对病情的严重程度和转归进行评定。结果 2组CD+4CD+25Tr细胞百分率和的临床相对计分在治疗后6个月差异无统计学意义(P0.05)，治疗后12个月差异有统计学意义(P0.01)。结论 胸腺切除后12个月重症肌无力患者的CD+4 CD+25Tr细胞的百分率明显增高，肌无力症状稳定或缓解。 　　【关键词】 重症肌无力;T淋巴细胞，调节性;免疫抑制剂;胸腺切除术;治疗结果 　　Clinical observation on the changes of CD+4CD25Tr cells after treatment for myasthenia gravis QI Guoyan*,ZHENG Xuguang,YANG Hong*,et al.*Department of Oncology, The First Hospital of Shijiazhuang City, Shijiazhuang 050011, China 　　【Abstracts】 Objective To observe the therapeutic effect of immunodepressant after thymusectomy in patients with myasthenia gravis (MG).Methods 50 patients with myasthenia gravis in group A were treated with immunodepressant after thymusectomy,however,the other 50 patients with myasthenia gravis were treated with immunodepressant without thymusectomy. The percentage of CD+4CD+25Tr cells were detected by flow cytometry before treatment and after 6month and 12month treatment, and the clinical severity and prognosis of MG were evaluated by Xus clinical scoring system. Results There was no significant difference in CD+4 CD+25Tr cells percentage after 6month treatment between two groups (P0.05),however, there was a significant difference in CD+4 CD+25Tr cells percentage after 12month treatment between two groups (P0.01).Conclusion The CD+4 CD+25Tr cells percentage is obviously increased 12 months after thymusectomy in patients with MG, and the symptoms of MG are relieved. 　　【Key words】 myasthenia gravis;T lymphocyte, regulation; immunodepressant;thymusectomy;treatment outcome 　　重症肌无力(myasthenia gravis, MG)是神经肌肉接头处传递功能障碍疾病，是由乙酰胆碱受体抗体介导，T细胞依赖，补体参与的自身免疫性疾病,细胞免疫调节异常是本病重要的发病机制之一[1]。我们利用流式细胞仪检测MG患者的外周血T细胞亚群CD+4CD+25Tr细胞的百分率，动态观察在治疗前和应用免疫抑制剂治疗后6和12个月的变化，应用许氏临床评分法[2]观察MG患