重症肌无力病人乙酰胆碱受体抗体的测定及临床意义

用ＥＬＩＳＡ（固相酶联免疫吸附）法测定１７２例ＭＧ病人血清乙酰胆碱受体抗体（ＡｃｈＲａｂ），结果显著高于健康献血员组和非ＭＧ病人组。不同性别、病程及临床类型与ＡｃｈＲａｂ无相关性，但４１～５０岁组的显著高于其他年龄组。６７例类固醇激素治疗组、２２例大剂量两种球蛋白治疗组、１２例胸腺切除术组及３例ＭＧ危象病人２４次血浆交换疗法（ＰＥ）组，治疗后伴随肌无力症状的好转，ＡｃｈＲａｂ均显著低于治疗前。结果表明：ＡｃｈＲａｂ测定为ＭＧ诊断提供了可靠的实验依据，为类固醇激素、大剂量丙种球蛋白、胸腺切除术和ＰＥ等治疗ＭＧ提供理论依据和疗效评定的实验指标，进一步证实了ＭＧ免疫学发病机理。

The measurement and significance of sera acetylcholine receptor antibodies in patients with myasthenia gravis

With solid-phase enzyme-linked immunosor bent assay (ELISA), we measured the antibodies to acetylcholine receptor (AchRab) in sera from 172 cases of myasthenia gravis (MG).The mean titer of AchRab in MG patients was significantly higher than those in healthy donors and non-MG pa tients. There was no correlations between the AchRab titers and sex, duration or clinical type,but the mean titer of AchRab in the group of pa tients aged from 41-50 years old was much higherthan those in other groups. The AchRab titers de creased significantly after the treatments with steroids (67 cases), thymectomy (12 cases), high dose intravenous immunoglobulins (22 cases) and plasma exchange (3 cases 24 times), and the clinical symptoms were improved. These indicate that the measurement of AchRab may give a reliable laboratory evidance for the diagnosis and treatment ofMG, and confirm the immunopathological mech anism of MG.