摘要
目的 研究重症肌无力（ＭＧ）患者细胞免疫的异常改变和糖皮质激素及胸腺切除对各淋巴细胞亚群的影响。方法 采用免疫荧光双标记技术和流式细胞仪对３９ 例ＭＧ患者和１８ 例健康对照者周围血中淋巴细胞表型分析，并对１５ 例ＭＧ患者经糖皮质激素治疗前后和７ 例ＭＧ 患者在胸腺切除前后各淋巴细胞亚群的百分率的变化进行观察。结果 （１） ＭＧ 患者总Ｔ细胞、总Ｂ 细胞（ＣＤ＋１９） 、传统Ｂ细胞（ＣＤ－５ ＣＤ＋１９）、ＣＤ＋４ Ｔ淋巴细胞的百分率与对照相比差异无显著性，但ＣＤ＋８ Ｔ细胞的百分率明显高于对照组；在ＣＤ＋４ Ｔ细胞的亚群中，ＭＧ患者的ＣＤ＋４ ＣＤ４５ＲＡ＋ 细胞明显低于对照组，而ＣＤ＋４ ＣＤ４５ＲＡ－ 细胞明显高于对照组；ＣＤ＋５ Ｂ细胞（ＣＤ＋５ ＣＤ＋１９） 的百分率在ＭＧ 组明显高于对照组。（２）用糖皮质激素后周围血中总Ｔ细胞（ＣＤ＋５ ） 、总Ｂ 细胞（ＣＤ＋１９） 、传统Ｂ细胞（ＣＤ５ＣＤ＋１９） 、ＣＤ＋５ Ｂ 细胞、ＣＤ＋４ Ｔ细胞、ＣＤ＋８ Ｔ细胞和ＣＤ＋４ ＣＤ４５ＲＡ－ 细胞百分率明显下降。（３） 胸腺切除后各淋巴细胞亚群无显著性改变。结论 ＭＧ细胞免疫的改变不仅有ＣＤ＋４ 、ＣＤ＋８ Ｔ细胞的变化，而且ＣＤ＋４ Ｔ?
Objective To study the abnormalities of cellular immunity of myasthenia gravis (MG) and the effects of glucocorticoid (GC) therapy and thymectomy on lymphocyte subsets in patients with myasthenia gravis. Methods Phenotypic analysis of peripheral blood lymphocyte in 39 patients with MG and 18 healthy controls were completed using flow cytometry and immunofluorescence double staining methods; changes of lymphocyte subsets were studied in 15 of the MG patients after GC therapy and 7 of the MG patients after thymectomy. Results (1) The percentage of pan T (CD + 5)、pan B (CD + 19 )、traditional B cell、CD + 4T cell in patients with MG did not significantly differ from that in healthy controls. An increase in CD + 8 cell was observed in MG patients as compared with normal controls. Among the CD + 4T lymphocyte subsets, there was significant decrease of the percentage of CD + 4CD 45 RA + (suppressor inducer) and increase of the percentage of CD + 4CD 45 RA -(helper inducer) subsets in MG patients than controls; the percentage of CD + 5 B cell was significantly increased in MG patients as compared with that in healthy controls. (2) After GC therapy, the percentages of pan T(CD + 5) 、pan B(CD + 19 )、traditional B cell、CD + 4T cell、CD + 8T cell、CD + 4CD 45 RA -、CD + 5B cell decreased. (3) After thymectomy, the proportions of T、B lymphocyte subsets did not change significantly. Conclusion Not only changes of T cell subsets (CD + 4 and CD + 8 T lymphocyte subsets) were shown, but also there were abnormal changes of functional CD + 4 T lymphocyte subsets and CD + 5 B lymphocyte which may play an important role in the pathogenesis of MG. There is comprehensive inhibiting action of GC on cellular immunity in MG patients, while there is no such effect with thymectomy on the lymphocyte subsets in MG patients.
出处
《中华内科杂志》
CAS
CSCD
北大核心
1999年第10期656-659,共4页
Chinese Journal of Internal Medicine
