胸腺基质淋巴细胞生成素对重症肌无力患者外周血中调节性T细胞的变化影响

目的：探讨胸腺基质淋巴细胞生成素对重症肌无力患者外周血中调节性T细胞的变化影响。方法：2008年9月到2013年12月选择在我院神经内科诊治的重症肌无力患者120例,都给予胸腺切除手术治疗,对预后情况进行观察与分析,对胸腺基质淋巴细胞生成素的表达与外周血中调节性T细胞的变化进行分析。结果：120例患者术后总有效率为91.7%,术后患者的CD4+CD25 Foxp3 /CD4 值明显高于对照组(P<0.05)。HE染色可见髓质部淋巴细胞增生与部分Hassall小体；免疫组化染色可见中髓质部Hassall小体数量明显减少,染色稍浅。相关性分析显示TSLP阳性表达的Hassall小体计数与CD4 CD25 Foxp3 Treg细胞表达水平之间存在呈线性相关(P<0.05)。Logistic回归模型分析结果表明CD4 CD25 Foxp3 /CD4 值和TSLP阳性表达是影响有效率的独立危险因素(P<0.05)。结论：胸腺切除手术是治疗重症肌无力疗效好,其机制在于能够有效维持免疫稳态功能,调节T细胞与胸腺基质淋巴细胞生成素的表达变化,保持患者健康。

The thymic stromal lymphopoietin and peripheral blood regulatory T cells changes in the myasthenia gravis patients

Objective: To investigate the thymic stromal lymphopoietin and peripheral blood regulatory T cells changes in the myasthenia gravis patients. Methods: Selected 120 myasthenia gravis patients from September 2008 to December 2013 in our hospital, all patients were given thymectomy surgery, the prognosis of the situation were observed and analyzed, the thymic stromal lymphopoietin and peripheral blood regulatory T cells changes were analyzed. Results: The total postoperative effective rate was 91.7%, and the postoperative CD4 CD25 Foxp3 / CD4 value was significantly higher (P <0.05).HE staining was showed the medulla lymphoproliferative with some Hassall corpuscles; immunohistochemical staining were showed the reduced the number of Hassall corpuscles in the medulla and stained slightly was lighter. Correlation analysis showed the presence of Hassall corpuscle counts with TSLP expression were related to the CD4 CD25 Foxp3 Treg cells (P <0.05). Logistic regression analysis showed that the CD4 CD25 Foxp3 / CD4 levels and TSLP expression levels were the independent risk factors for the postoperative effective rate (P <0.05). Conclusion: Thymectomy surgery has better effect for the treatment of myasthenia gravis, the mechanism may be related to effectively regulate the expression of T cells and thymic stromal lymphopoietin so as to maintain immune homeostasis function.