重症肌无力患者的抗横纹肌抗体测定

100例重症肌无力患者血清中抗横纹肌抗体阳性率为47%。伴胸腺肿瘤的重症肌无力患者其阳性率为80%,不伴胸腺瘤者仅为45%,抗横纹肌抗体阴性则伴胸腺瘤的可能性较小。     

重症肌无力患者抑郁障碍的患病状况调查

目的探讨重症肌无力患者合并抑郁障碍的发生率及其相关因素。方法采用汉密顿抑郁量表（HAMD量表）对58例重症肌无力患者进行问卷调查。结果 21例（36.21%）患者合并抑郁障碍,其中轻度抑郁12例（57.14%）,中度抑郁7例（33.33%）,重度抑郁2例（9.53%）;文化程度高、病程长、Ⅲ和Ⅳ型重症肌无力患者抑郁发生率明显增高（P〈0.05）。结论重症肌无力患者抑郁发生率较高,文化程度、病程及临床分型影响抑郁的发生。     

重症肌无力患者循环免疫复合物的初步研究

作者报告用牛胶固素酶联免疫吸附试验,检测43例重症肌无力患者和50例正常人血清中的循环免疫复合物,结果发现MG患者的循环免疫复合物水平(12.2±3.6μg AHG/ml)明显高于正常人(6.6±1.9μgAHG/ml)(P<0.01)。眼型及全身型MG患者的循环免疫复合物水平均高于正常人(P<0.01),而全身型MG患者的循环免疫复合物水平高于眼型患者,但无显著性差异。作者还观察到经免疫抑制治疗的患者与未经免疫抑制治疗的患者血清中循环免疫复合物水平也无显著差异(P>0.05)。     

TUMOR NECROSIS FACTOR-ALPHA POLYMORPHISM AND SECRETION IN MYASTHENIA GRAVIS

Objective To analyze the relationship between tumor necrosis factor-alpha (TNFo) gene promoter -308 polymorphism and myasthenia gravis (MG) in Chinese and analyze secretion of TNFo in peripheral blood mononuclear cells (PBMC) in MG patients.Methods A biallelic polymorphism at position -308 in the promoter of TNFα gene was screened by PCR amplification and NcoI recognition site. One hundred and twenty-three MG cases and 115 healthy controls were included in this study. MG patients were classified to different groups according to clinical type, age at onset, and sex respectively. PBMC were isolated from 20 patients and 20 healthy controls, and then cultured in the presence or absence of phytohemagglutinin (PHA) and acetycholine receptors (AchR). The supernatants were harvested after incubation and stored until TNFαwas assayed by enzyme-linked immunosorbent assay.Results The frequency of TNFα-308 allele 2 (A) was found significantly increase in MG patients and showed a trend especially in late onset (≥ 40 years) and male patients (P ＜ 0.05). The allele A had no relationship with thymic pathogenesis in MG patients. But frequency of allele A was significantly higher in general type than in ocular type (P ＜ 0.05). MG patients had a higher inducible level of TNFα by PHA and AchR, and could be down regulated after treatment.Conclusion Polymorphism in TNFα gene promoter -308 is associated with onset of MG. The microsatellite allele TNFα2 confer risk for the development of MG in Chinese patients. MG patients have a higher inducible level of TNFα.     

胸腺切除治疗重症肌无力临床探讨

自1966年3月～1994年10月，采用胸腺切除术治疗各型重症肌无力122例。所有病例的胸腺均经病理检查，胸腺异常为95．1％，其中胸腺瘤占37．7％，恶性胸腺癌占胸腺瘤的67．4％。术后47．5％的病例发生了重症肌无力危象，该危象多见于ⅡB和Ⅲ型病例。6．5％的病例在院死亡。术后对106例进行了6个月至28年随访，症状缓解和改善者占68．9％，无变化者占8．5％，术后离院与本病有关死亡者为17．9％。该文认为，病情严重ⅡB、Ⅲ型病例胸腺切除早期行气管切开术，酌情使用人工呼吸机，是预防和治疗重症肌无力危象的重要方法，有助于降低围手术期死亡率。     

ABC-ELISA测定重症肌无力患者血清抗乙酰胆碱受体抗体水平的研究

采用ABC-ELIsA法检测了50例重症肌无力(MG)患者,20例其它中枢神经系统(CNS)疾病患者及30例正常人血清。发现:临床对照及正常对照组乙酰胆硷受体抗体(AchRAb)均为阴性。50例MG中有21例阳性(42%),全身型MG阳性率明显高于单纯眼肌型(P<0.005),随着病程延长,病情好转,大多患者的AchR抗体OD值呈下降转阴趋势。个别病例抗体比值与临床不符,可能是由于AchRAb的异质性所造成。ABC-ELISA法简便、快速可靠,为MG深入研究提供了有效手段。     

重症肌无力病人抗乙酰胆碱受体抗体的检测及其临床意义

用与乙酰胆碱受体（ＡｃｈＲ）特异性结合的α－银环蛇毒素（α－ＢＧＴ）包被酶标板提纯肌肉粗提液中的ＡｃｈＲ作为抗原，按ＡＢＣ－ＥＬＩＳＡ间接法检测了５１例正常对照组，５２例临床对照组及９６例（１１０次）重症肌无力（ＭＧ）病人血清中的ＩｇＧ乙酰胆碱受体抗体（ＩｇＧ－ＡｃｈＲａｂ）。结果发现ＩｇＧ－ＡｃｈＲａｂ在ＭＧ组有３９例阳性（４４次）（４０．６３％）。临床对照组４例阳性（７．６９％）。正常对照组２例阳性，统计学处理发现ＭＧ组与其它组差异均有显著性（Ｐ＜０．０５），而临床对照组与正常对照组差异无显著性（Ｐ＞０．０５）。     

血浆置换联合小剂量激素治疗重症肌无力的疗效观察

目的观察血浆置换联合小剂量激素治疗重症肌无力的临床疗效及安全性.方法将20例重症肌无力患者随机分为两组:治疗组10例,采用血浆置换,每次置换量2000ml、甲基强的松龙2～3mg/(kg·d),连用5d;对照组10例,单纯采用甲基强的松龙15～20mg/(kg·d)冲击治疗,连用3d.观察两组近期临床疗效及安全性.结果两组的临床绝对评分和相对评分比较,治疗组明显优于对照组,P＜0.05.结论采用血浆置换联合小剂量甲基强的松龙治疗重症肌无力,效果好,安全性高,是一种理想的治疗方法.     

34例重症肌无力患者血浆纤联素等含量的测定

本文以单向琼脂免疫扩散法对34例重症肌无力患者的PFN等含量进行了测定,结果发现,重症肌无力患者的PFN, IgA 含量较正常人低(P<0.001,P<0.05),IgA、C_3较正常人增高(P<0.001,P<0.05),且差异都具有非常显著性意义和显著性意义。因而提示PFN、IgG、IgA、C_3含量的测定可作为诊断重症肌无力的参考指标之一。     

23例重症肌无力心脏收缩间期的测定

本文测定了23例重症肌无力患者的心脏收缩间期,发现11例的心脏射血前间期与左室射血时间之比大于0.41,示左室功能肯定异常,肌注新斯的明后有8例的心功转为正常或趋于正常.因此,从研究结果发现,重症肌无力患者的心肌损害多为肌无力性质,且本病的心肌损害比临床上估计的更为多见.     

重症肌无力症134例放射治疗的疗效分析

本文回顾分析我院自1961年5月至1985年12月重症肌无力症134例主要采用胸腺放疗的结果。其中25例用深部经X线照射,109例~(60)Co放疗。随访时间2月至24年。完全缓鲜26例(19.5％),显著好转63例(47％),合计显效率为66.5％。56例仅接受放疗或同时服用抗胆碱酯酶剂,可以作为组内自身对照,证实放疗疗效较好。胸腺区或脾区放疗后患者血清nAchRab及淋巴细胞总数降低,具有抗淋巴细胞作用,能抑制自身免疫应答。如今放射治疗对MG已经不是经验性治疗,而是一种值得推荐的免疫调整治疗方法。本文初步提出治疗适应证。     

DISCHARGE RESPONSE OF CEREBELLAR PURKINJE CELLS TO STIMULATION OF C-FIBER IN SAPHENOUS NERVE

Experiments were Performed on cats under chloralose anaesthesia and immobilized byflaxidel.The discharge responses of cerebellar Purkinje’s cells(PC)were recorded with a microelec-trode.When the saphenous nerve was stimulated at a lower intensity,which elicited the A-fiber input-only,a discharge response A-CED)which consisted of an early component wiith latency of16.7士0.gms and a late component with latency of270.8土12.8ms was recorded in PC.After A-fibers wereblocked selectively by the polarizing current,the stimulation at the strength of C-fiber suprathreshold e-voked a characteristic response(C-CED)of PC with a latency of142.4土4.3ms.However,the C-CEDcould not be evoked by the inputs of A-and C-fibers simultaneously.     

小儿重症肌无力的类固醇疗法

本文报告了用类固醇治疗的80例小儿重症肌无力,有效率100%,1/3以上达远期完全缓解.作者发现,中等剂量、缓慢减量和较短疗程(1—2年)的方法,可使相当多的患儿有较早获得停用一切药物达长期完全缓解的机会,且小儿用类固醇疗法获长期完全缓解的机会较成人明显增多.1/3以上的患儿不需象成人那样长期持续治疗.     

EXPRESSION AND SUBCELLULAR LOCALIZATION OF P9-ZFD PROTEIN IN PATIENTS WITH MYASTHENIA GRAVIS

Objective To express and purify the protein coded by the TRAF-type zinc finger domain of myasthenia gravis (MG)-related gene P9 ( P9-ZFD ) and to prepare P9-ZFD antiserum for detecting expression and subcellular distribution of P9-ZFD protein in the skeletal muscles of patient with MG. Methods The cDNA encoding P9-ZFD was amplified by RT-PCR. The cloned P9-ZFD cDNA was ligated into pET24a, and the P9-ZFD recombinant protein was induced via E.coli. BL21 (DE3) and purified by histidine affinity chromatography. P9-ZFD antiserum was prepared and its titer and specificity were determined by ELISA and Western blot. Expression and subcellular distribution of P9-ZFD protein in the skeletal muscles of MG and control were studied. Results The molecular weight of purified P9-ZFD protein was about 30kD. Its purity was more than 95%. Antiserum specific for P9-ZFD was excellent. P9-ZFD protein is fully confined to the cytoplasm membrane of skeletal muscle cell of MG, obvious immunostaining was absent in the A, I, and Z bands of cytoplasm and no immunoreactivity was observed in the skeletal muscle cell of control. Conclusion P9-ZFD protein is expressed as a cytoplasm membrane-bound protein and has obvious distribution difference in the skeletal muscle cells of patient with MG and normal control.     

α肾上腺素能激动剂的变时性成熟性变化

应用不同浓度的α肾上腺素能激动剂和阻滞剂对比观察新生犬心脏的变时性效应。实验结果证明新生犬心脏的变时性效应发生成熟性变化。     

重症肌无力患者血清的红细胞免疫粘附抑制活性的探讨

作者研究了重症肌无力患者血清对正常人红细胞免疫粘附功能的抑制作用,发现:65％的患者血清对正常人红细胞C_3b(RBC-C_3b)受体花环的形成具有抑制作用。全身型患者的血清抑制活性明显高于眼型患者(P<0.01),提示血清抑制作用与疾病的临床类型有关。作者还发现血清抑制活性与患者的RBC-C_3b受体花环率降低以及循环免疫复合物(CIC)水平升高有一定关系。并证明患者血清中的CIC本身就具有红细胞免疫粘附抑制活性。     

e抗原阳性产妇之婴儿对乙肝疫苗免疫效果观察

本文报告用国产乙肝血源疫苗接种于e抗原阳性产妇之新生儿观察免疫后抗体的持续时间和保护状态。36名中31名产生抗-HBs,经5～6年,其中16名幼儿的抗-HBs仍在10mIU/ml以上,占61.29%,抗-HBs降到10mIU/ml以下者12名,占38.71%。36名婴儿初免后,6个月内HBsAg阳转者5人,到5年时仍为阳性,均演变为HBsAg慢性携带者。31名抗-HBs阳性的幼儿中,5～6年时有6人被HBV感染,表现抗-HBc阳性,但其HBsAg仍为阴性。HBV感染与抗体滴度偏低有关。抗体消失或降到10mIU/ml以下时,宜进行乙肝疫苗再接种,以增强其免疫能力。     

重症肌无力病人外周血单个核细胞TGF-β及IL-6水平的测定

①目的　探讨转化生长因子 β(TGF β)及白细胞介素 6 (IL 6 )与重症肌无力 (MG)病人发病的关系。②方法　利用体外细胞培养方法和ELISA法 ,检测 34例MG病人及 2 0例健康对照者外周血单个核细胞经乙酰胆碱受体 (AchR)刺激后细胞培养上清液中TGF β、IL 6水平。 ③结果　MG病人外周血单个核细胞TGF β、IL 6水平高于正常对照组 (t=2 .0 1、2 .18,P <0 .0 5 ) ;且TGF β水平与病程有关 (F =3.32 ,q =3.82 ,P <0 .0 5 )。 ④结论MG病人自身免疫功能异常 ,TGF β及IL 6参与了MG的免疫病理过程