Neuromuscular Division, Department of Neurology, Box 3403, Duke University Medical Center, Durham, North Carolina, 27710.
Muscle Nerve. 2014 Apr;49(4):483-6. doi: 10.1002/mus.23944.
The objective of this study is to determine if change in acetylcholine receptor antibody (AChR-ab) levels reflects change in clinical severity in patients with myasthenia gravis (MG).
We reviewed results from a prospective trial in MG and from all 85 patients in an MG Clinic who had AChR-ab determinations performed at least twice by the same commercial laboratory.
Change in AChR-ab levels correlated only weakly with change in clinical severity. AChR-ab levels fell in 92% of patients who improved and in 63% who did not. A fall in AChR-ab level had a positive predictive value for clinical improvement of 83% and a negative predictive value of only 59%.
AChR-ab levels fell in almost all patients who improved, but also in most patients who did not. Thus, we do not recommend commercially available AChR-ab levels as a biomarker of improvement in MG. However, antibody levels might be useful as a marker for inadequate immunotherapy.
本研究的目的是确定乙酰胆碱受体抗体（AChR-ab）水平的变化是否反映重症肌无力（MG）患者临床严重程度的变化。
我们回顾了一项前瞻性 MG 研究的结果，以及在同一家商业实验室至少进行了两次 AChR-ab 检测的 85 名 MG 诊所患者的所有结果。
AChR-ab 水平的变化与临床严重程度的变化只有微弱的相关性。92%的病情改善患者和 63%的病情未改善患者的 AChR-ab 水平下降。AChR-ab 水平下降对临床改善的阳性预测值为 83%，阴性预测值仅为 59%。
几乎所有病情改善的患者 AChR-ab 水平下降，但也有大多数病情未改善的患者 AChR-ab 水平下降。因此，我们不建议将商业上可获得的 AChR-ab 水平作为 MG 改善的生物标志物。然而，抗体水平可能是免疫治疗不足的有用标志物。
