免疫球蛋白对重症肌无力细胞免疫机制影响.docVIP

免疫球蛋白对重症肌无力细胞免疫机制影响【摘要】 目的 探讨静脉注射免疫球蛋白(intravenous immunoglobulin IVIG)对重症肌无力(myasthenia gravis，MG)细胞免疫机制的影响，为临床提供理论基础。方法 采用IVIG治疗MG患者12例，在IVIG 治疗0天和治疗后第5天，观察MG肌无力临床绝对评分及治疗前后INF-γ、IL-4变化。结果 IVIG治疗后，临床绝对评分(15.083±3.204)下降，与治疗前(19.083±2.539)比较P0.01；INF-γ阳性细胞数(0.857±0.176)下降、IL-4阳性细胞数(0.699±0.138)增加，与治疗前(1.035±0.235，0.584 ±0.129)比较均P0.05 。结论 IVIG治疗MG患者能有效改善MG患者肌无力症状，抑制Th1细胞因子分泌，促进Th2细胞因子分泌。 【关键词】重症肌无力；静脉注射免疫球蛋白； 干扰素-γ；白介素-4 Effect of intravenous immunoglobulin on cell immunity of myasthenia gravis patients WU Huai-guo，PENG Xiao-jiang，WU Yuan-bo，et al.Department of Neurology，Anhui Provincial Friendship Hospital，Hefei230011，China 【Abstract】 Objective To investigate Effection of intravenous immunoglobulin(IVIG) on cell immunity mechanism of myasthenia gravis (MG)patients and provide a theory basis for clinical medication.Methods Twelve MG patients were treated for 5 days with IVIG and evaluated the clinical severity of MG at the day before treatment and the 5th day after treatment by Xu′sclinical scoring system，the INF-γ and IL-4 positive peripheral blood lymphocyte were determined by flow cytometry.Results Compared with pretherapy，the clinical score of MG were decreased post-treatment(19.083±2.539）,（15.083±3.204），（P0.01)，the INF-γ and IL-4 positive peripheral blood lymphocyte were lower post-treatment(1.035±0.235），（0.857±0.176），（P0.05)and the INF-γ and IL-4 positive peripheral blood lymphocyte were increased post-treatment(0.584 ±0.129）,（0.699±0.138），（P0.05).Conclusion The symptom of MG patients can be ameliorate by treated with IVIG..Inhibits production of Th1 cytokines and promotes production of Th2 cytokines maybe the probably mechanism. 【Key words】Myasthenia gravis; Intravenous immunoglobulin; Interferon-gamma; Interleukin-4 重症肌无力(myasthenia gravis，MG)主要是由乙酰胆碱受体抗体(acetylcholine receptor anti-body，AchR-Ab)介导、细胞免疫依赖和补体参与的神经-肌肉接头处的自身免疫性疾病。T淋巴细胞在起始和调节针对抗原的免疫反应方面发挥了十分重要的作用，也即AChR抗体的产生是T细胞依赖性的。因此，抑制T细胞活化、增殖是当前MG研究的热点、难点.上世纪80年代始，应用大剂量免疫球蛋白(intravenous imm