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[胸腺切除术和糖皮质激素治疗对重症肌无力患者外周淋巴细胞的影响]

[Effects of thymectomy and glucocorticoid therapy on peripheral lymphocytes in myasthenia gravis].

作者信息

Huang Y, Xu X, Lin J

机构信息

Peking Union Medical College Hospital, Beijing.

出版信息

Zhonghua Nei Ke Za Zhi. 1995 Aug;34(8):514-7.

PMID:8697907
Abstract

Clinical manifestations and peripheral blood lymphocyte subset changes were studied in patients with myasthenia gravis (MG) to elucidate the mechanism of clinical improvement following treatment, with thymectomy (Tx) or glucocorticoid (GC) therapy. The changes found were: 1. There was a significant increase in percentages of CD3+, CD29+ CD4+ cells and CD4/CD8 ratio and a significant decrease in percentages of CD8+ and CD16,56+ cells in patients who had never been treated with any immune therapy. 2. After Tx or GC therapy, CD3+ and CD4+, CD29+ cells were decreased, but the number CD19+ and CD16, CD56 cells did not change. 3. Tx had a special effect on CD8+ cells. In most of the patients who showed clinical improvement after Tx, CD8+ cells were increased and CD4/CD8 ratio wad decreased. 4. Anti-acetylcholine receptor (AChRAb) titers were markedly decreased after GC therapy. These results indicate that there were obvious abnormalities in cell-mediated immunity in addition to those in humoral immunity in myasthenia gravis. These abnormalities tended to be normalized after Tx or GC therapy.

摘要

对重症肌无力(MG)患者的临床表现及外周血淋巴细胞亚群变化进行了研究,以阐明胸腺切除术(Tx)或糖皮质激素(GC)治疗后临床改善的机制。发现的变化如下:1. 从未接受过任何免疫治疗的患者中,CD3 +、CD29 + CD4 +细胞百分比及CD4/CD8比值显著升高,CD8 +和CD16、56 +细胞百分比显著降低。2. Tx或GC治疗后,CD3 +和CD4 +、CD29 +细胞减少,但CD19 +和CD16、CD56细胞数量未变。3. Tx对CD8 +细胞有特殊影响。在大多数Tx后临床改善的患者中,CD8 +细胞增加,CD4/CD8比值降低。4. GC治疗后抗乙酰胆碱受体(AChR)抗体滴度显著降低。这些结果表明,重症肌无力除体液免疫异常外,细胞介导免疫也存在明显异常。Tx或GC治疗后这些异常倾向于恢复正常。

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