免疫抑制剂对重症肌无力病人T淋巴细胞亚型的影响

目的观察重症肌无力(MG)病人细胞免疫的异常改变和免疫抑制剂对重症肌无力(MG)病人的临床疗效及对T淋巴细胞亚型的影响。方法用许氏评分法观察60例MG病人的病情严重程度和免疫抑制治疗2个月后的临床疗效;采用直接免疫荧光染色和流式细胞仪技术测定60例病人和60名志愿健康者周围血中T淋巴细胞亚型的百分率,并测定糖皮质激素或环磷酰胺免疫抑制治疗前及治疗后2个月T淋巴细胞亚型的变化。结果未治疗MG组外周血中CD8 T淋巴细胞的百分率较正常对照组显著下降(P<0.01);CD4 T淋巴细胞的百分率和CD4 /CD8 T细胞的比例较正常对照组均显著升高(P<0.01)。经激素或环磷酰胺治疗2个月后MG组随着临床症状的改善,外周血中总T细胞(CD3 )和CD8的百分率较治疗前均显著升高(P<0.01;P<0.05);CD4 T淋巴细胞的百分率和CD4 /CD8 T细胞的比例较治疗前均显著下降(P<0.01)。结论MG病人有T淋巴细胞亚型的变化,免疫抑制治疗对T淋巴细胞亚群有明显影响,提示T淋巴细胞亚型的测定可为激素、环磷酰胺等免疫疗法提供一个客观的实验室指标,为判断疾病的转归提供实验依据。

Effect of immunologic treatment on lymphocyte in patients with myasthenia gravis

Objective To study the abnormalities of cellular immunity of myasthenia gravis(MG) and the effects of glucocorticoid(GC) and cyclophosphamide therapy on lymphocyte subsets in patients with MG.MethodsPhenotypic analysis of peripheral blood lymphocyte in 60 patients with MG and 60 controls were completed using flow cytometry and immunofluorescence staining methods.Changes of lymphocyte subsets were studied in 60 MG patients after GC or cyclophosphamide therapy.ResultsThe percentage of CD8 T cells decreased significantly compared with normal controls(P<0.01)before treatment,and increased significantly(P<0.01;P<0.05) after treatment.The percentage of CD4 T cells and CD4 /CD8 ratio was higher in patients with MG than that of controls(P<0.01)before treatment,and decreased significantly(P<0.01)after treatment.ConclusionThere are abnormalities of cellular immunity in MG patients.There are significant changes of T cells subsets in patients with MG before and after treatment.The results indicat that phenotypic analysis of peripheral blood lymphocyte is valuable in providing immunological parameters of therapeutic evaluation in MG and further demonstrated immunological pathogenesis of MG.