胸腺切除术作为重症肌无力以外的自身免疫性疾病的治疗方法。

Thymectomy as treatment of autoimmune diseases other than myasthenia gravis.

作者信息

D'Andrea V, Malinovsky L, Ambrogi V, Artico M, Capuano L G, Buccolini F, De Antoni E

机构信息

Department of Cardiovascular and Respiratory Sciences, La Sapienza University of Rome, Italy.

出版信息

Thymus. 1993 Feb;21(1):1-10.

PMID:8480342

Abstract

This paper reviews the different series of thymectomies performed in patients with autoimmune diseases other than myasthenia gravis. It is possible that thymectomy can decrease the activity of T-helper lymphocytes or, alternatively, it may enhance the activity of T-suppressor lymphocytes, whose function is depressed in autoimmune diseases. Thymectomy was performed empirically for systemic lupus erythematosus and rheumatoid arthritis. The therapeutic benefits were questionable. Conflicting results were reported for thymectomy against autoimmune hemolytic anemia. Several trials were conducted to assess the therapeutic value of thymectomy in multiple sclerosis. Benefits were achieved only in relapsing-remitting but not in chronic-progressive multiple sclerosis. The effect of thymectomy in autoimmune diseases associated with myasthenia gravis were also reported. The authors conclude that thymectomy as treatment for autoimmune diseases other than myasthenia gravis is not elective therapeutic choice and it is acceptable only in selected cases.

摘要

本文回顾了在重症肌无力以外的自身免疫性疾病患者中进行的不同系列胸腺切除术。胸腺切除术有可能降低辅助性T淋巴细胞的活性，或者，它可能增强抑制性T淋巴细胞的活性，而抑制性T淋巴细胞的功能在自身免疫性疾病中受到抑制。胸腺切除术曾经验性地用于系统性红斑狼疮和类风湿关节炎。其治疗益处存疑。关于胸腺切除术治疗自身免疫性溶血性贫血的结果相互矛盾。进行了多项试验以评估胸腺切除术在多发性硬化症中的治疗价值。仅在复发缓解型多发性硬化症中取得了益处，而在慢性进展型多发性硬化症中未取得益处。也报道了胸腺切除术在与重症肌无力相关的自身免疫性疾病中的作用。作者得出结论，胸腺切除术作为重症肌无力以外的自身免疫性疾病的治疗方法并非选择性治疗选择，仅在特定病例中可接受。