重症肌无力患者血清连接素抗体与临床的关系

目的 探讨重症肌无力（MG）患者血清连接素抗体（Titin—Ab）水平与病情及胸腺异常的关系，以及其对诊断和预后判断的价值。方法 应用酶联免疫吸附法（ELISA）检测MG患者（MG组）52例、非MG（其他神经系统疾病）患者（NMG组）18例、健康对照者（NC组）50名血清中Titin—Ab水平，并对其中10例进行胸腺手术的MG患者随访。结果 MG组Titin—Ab阳性率为36．5％，NMG组和NC组均为阴性，MG组显著高于NC组和NMG组（均P〈0．01）；以MG伴胸腺瘤（MGT）组阳性率最高（83．3％），MG伴胸腺萎缩（MGA）次之（37．5％），胸腺正常的MG组为23．0％，MG伴胸腺增生组为阴性；Titin．Ab诊断MGT特异性高于胸腺CT（P〈0．05）。Titin—Ab阳性MG患者抗体水平与肌无力程度呈显著正相关（r=0．562，P〈0．01）；对10例不同胸腺病理类型的MG患者手术前后Titin—Ab测定显示差异具有显著性（P〈0．05）。结论 Titin—Ab阳性多见于MGT和MGA者，诊断MGT的特异性高于CT；Titin—Ab对MG的诊断、病情及预后判断均有帮助。

Relationship between clinical feature and serum Titin antibodies in patients with myasthenia gravis

Objective To investigate the correlation between level of Titin antibodies (Titin-Ab) and patient's condition and different thymic pathological patterns in patients with myasthenia gravis (MG), and to assess its value in the diagnosis and prognosis of MG.Methods The levels of Titin-Ab in serum from 52 patients with MG (MG group), 18 cases with other neurologic diseases (NMG group) and 50 normal controls (NC group) were detected using enzyme-linked immunosorbentassay (ELISA). 10 cases with MG who received operation on thymus were tested again after therapy.Results The positive rate of Titin-Ab in MG group was 36.5%,but not present in MNG and NC groups.The MG group!was significantly higher than those in NMG group and NC group (all P<0.01).Meanwhile,the highest percentage was 83.3% in MG with thymoma (MGT), then 37.5% in MG with thymic atrophy (MGA), 23.0% in MG with nomal thymic (MGN) and negative in MG with hyperplasia(MGH). Comparing with CT scanning, the specificity of Titin-Ab in diagnosis of MGT was higher ( P<0.05). There was a positive correlation between the level of Titin-Ab and severity of muscle weakness ( r=0.562, P<0.01). There was an obvious difference of Titin-Ab level in sera of 10 MG patients before and after operation ( P<0.05).Conclusions Positive Titin-Ab is mostly found in MGT and MGA, and its specificity is higher than CT scan in diagnosing MGT. Detection of Titin-Ab is helpful in diagnosing and evaluating patient's condition and prognosis of MG.