儿童眼肌型重症肌无力患者的AChRAb、IL12、补体成分和免疫球蛋白水平分析
发布时间：2019-04-10 14:15
【摘要】：目的 检测儿童眼肌型重症肌无力（OMG）患者血清IL12p40、AChRAb、C3、C4、IgG、IgM、IgA水平及IL12p40p70~+PBMC百分率，探讨其在儿童眼肌型重症肌无力发病中的作用。 采集2011年1月至2012年2月期间，在华中科技大学同济医学院附属同济医院神经内科门诊确诊的66例儿童眼肌型重症肌无力患者及55例正常对照儿童的外周血，利用酶联免疫吸附试验（ELISA）检测外周血IL12p40及AChRAb水平;采用流式细胞技术检测IL12p40p70~+PBMC百分率;通过同济医院检验科获得血清IgG、IgM、IgA、C3、C4结果，采用SPSS18.0软件进行统计学分析。 结果 66例儿童OMG患者中，AChRAb阳性48例，占73%，其中女性AChRAb阳性率为69%，男性为76%。 儿童OMG组IL12p40p70~+PBMC百分率与正常儿童组无统计学差异。亚组分析显示，无论是否使用糖皮质激素（GC），AChRAb是否阳性，该项指标OMG患儿与正常儿童相比均无统计学差异，P0.05。 在甲状腺及胸腺正常的OMG儿童中，无论是否使用GC，血清IL12p40水平均高于正常对照，未使用GC的患者IL12p40水平显著高于使用GC的患者，P0.05。 在甲状腺及胸腺正常且使用GC的OMG儿童中，无论AChRAb是否阳性，血清C3、C4及IgM水平水平均显著低于正常对照组，P0.05。无论AChRAb是否阳性，儿童OMG患者血清中C3与C4水平呈正相关。 10岁以上甲状腺及胸腺正常且使用GC的OMG儿童组血清IgG、IgA水平，与其正常对照组相比，无统计学差异，P0.05。 结论 大部分儿童OMG患者体内AChRAb阳性；L12p40参与了儿童OMG的免疫学发病机制；C3、C4可能主要通过补体经典激活途径发挥作用。中国的大部分儿童OMG和成人MG一样，属于自身免疫性疾病。
[Abstract]:Objective to investigate the role of serum IL12p40,AChRAb,C3,C4,IgG,IgM,IgA and IL12p40p70~ PBMC in the pathogenesis of ocular myasthenia gravis (OMG) in children with ocular myasthenia gravis (OMG). The peripheral blood samples were collected from 66 children with myasthenia gravis diagnosed from January 2011 to February 2012 in the Department of Neurology, Tongji Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology, and 55 normal children. The levels of IL12p40 and AChRAb in peripheral blood were measured by enzyme-linked immunosorbent assay (ELISA). Flow cytometry was used to detect the percentage of IL12p40p70~ PBMC and the results of serum IgG,IgM,IgA,C3,C4 were obtained by laboratory of Tongji Hospital. The results were analyzed statistically by SPSS18.0 software. Results among 66 children with OMG, 48 (73%) were AChRAb positive. The positive rate of AChRAb was 69% in female and 76% in male. There was no significant difference in the percentage of IL12p40p70~ PBMC between OMG group and normal group. Subgroup analysis showed that there was no significant difference between children with OMG and normal children regardless of whether glucocorticoid (GC), AChRAb was positive or not, P0.05. In OMG children with normal thyroid and thymus, the serum IL12p40 level of GC, was higher than that of normal controls, and the level of IL12p40 in non-GC patients was significantly higher than that in GC-treated children (P0.05). The levels of serum C _ 3, C _ 4 and IgM in OMG children with normal thyroid and thymic GC were significantly lower than those in normal controls (P0.05), regardless of whether AChRAb was positive or not. Whether AChRAb was positive or not, there was a positive correlation between C 3 and C 4 levels in children with OMG. There was no significant difference in serum IgG,IgA levels between normal thyroid and thymic OMG children over 10 years old and GC-treated children (P 0.05). Conclusion AChRAb is positive in most children with OMG, L12p40 is involved in the immunological pathogenesis of OMG in children, and C3, C4 may play a role in the classical activation of complement. Most Chinese children with OMG, like adult MG, are autoimmune diseases.
【学位授予单位】：华中科技大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R746.1
[Abstract]:Objective to investigate the role of serum IL12p40,AChRAb,C3,C4,IgG,IgM,IgA and IL12p40p70~ PBMC in the pathogenesis of ocular myasthenia gravis (OMG) in children with ocular myasthenia gravis (OMG). The peripheral blood samples were collected from 66 children with myasthenia gravis diagnosed from January 2011 to February 2012 in the Department of Neurology, Tongji Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology, and 55 normal children. The levels of IL12p40 and AChRAb in peripheral blood were measured by enzyme-linked immunosorbent assay (ELISA). Flow cytometry was used to detect the percentage of IL12p40p70~ PBMC and the results of serum IgG,IgM,IgA,C3,C4 were obtained by laboratory of Tongji Hospital. The results were analyzed statistically by SPSS18.0 software. Results among 66 children with OMG, 48 (73%) were AChRAb positive. The positive rate of AChRAb was 69% in female and 76% in male. There was no significant difference in the percentage of IL12p40p70~ PBMC between OMG group and normal group. Subgroup analysis showed that there was no significant difference between children with OMG and normal children regardless of whether glucocorticoid (GC), AChRAb was positive or not, P0.05. In OMG children with normal thyroid and thymus, the serum IL12p40 level of GC, was higher than that of normal controls, and the level of IL12p40 in non-GC patients was significantly higher than that in GC-treated children (P0.05). The levels of serum C _ 3, C _ 4 and IgM in OMG children with normal thyroid and thymic GC were significantly lower than those in normal controls (P0.05), regardless of whether AChRAb was positive or not. Whether AChRAb was positive or not, there was a positive correlation between C 3 and C 4 levels in children with OMG. There was no significant difference in serum IgG,IgA levels between normal thyroid and thymic OMG children over 10 years old and GC-treated children (P 0.05). Conclusion AChRAb is positive in most children with OMG, L12p40 is involved in the immunological pathogenesis of OMG in children, and C3, C4 may play a role in the classical activation of complement. Most Chinese children with OMG, like adult MG, are autoimmune diseases.
【学位授予单位】：华中科技大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R746.1
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