胸腺切除对重症肌无力患者T淋巴细胞亚型的影响

目的：观察胸腺切除(Tx)术对重症肌无力(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30例伴胸腺增生或胸腺瘤的MG患者的病情严重程度及Tx术后2个月的临床疗效；采用直接免疫荧光染色和流式细胞仪技术测定60名志愿健康者和30例伴胸腺增生或胸腺瘤的MG患者Tx术前及术后2个月T淋巴细胞亚型的变化。结果：伴胸腺增生或胸腺瘤的MG病人Tx术前外周血中CD4＋T淋巴细胞的百分率较正常人显著增多(P＜0．01)，CD8＋T淋巴细胞的百分率较正常人显著减少(P＜0．01)，CD4＋/CD8＋T细胞的比例明显增高(P＜0．01)。伴胸腺增生MG病人Tx术后随着临床症状的改善，CD8＋T淋巴细胞的百分率较术前显著升高(P＜0．05)，CD4＋/CD8＋T细胞的比例较术前显著下降(P＜0．05)。伴胸腺瘤MG病人Tx术后随着临床症状的改善，CD4+T淋巴细胞的百分率较术前显著下降(P＜0．05)，CD4＋/CD8＋T细胞的比例较术前显著下降(P＜0．05)。结论：重症肌无力患者T淋巴细胞亚型的测定既可以为MG免疫病理学的发病机理的研究提供实验依据，也能为Tx治疗MG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 thymectomy on lymphocyte in patients with myasthenia gravis

Objective: To study the abnormalities of cellular immunity of myasthenia gravis(MG) and the effects of thymectomy (Tx)on lymphocyte subsets in patients with MG. Methods: Phenotypic analysis of peripheral blood lymphocyte in 30 patients with MG and 30 controls were completed using flow cytometry and immunofluorescence staining methods; changes of lymphocyte subsets were studied in 30 MG patients after Tx therapy. Results; The percentage of CD8 T cells decreased significantly(P<0. 01) and that of CD4 T cells and CD4 /CD8 ratio increased significantly (P<0.01)as compared with normal controls before Tx. The percentage of CD8 T cells increased significantly(P