重症肌无力患者免疫相关指标检测结果分析

发布时间：2018-06-05 05:21

本文选题：重症肌无力 + 自身免疫抗体　；参考：《广西医科大学》2017年硕士论文

【摘要】：目的:本课题通过分析重症肌无力(Myasthenia Gravis,MG)患者的病例资料,以及免疫相关指标检测结果,旨在探讨各免疫指标在MG发病中的作用。方法:病例资料收集:从2012年1月到2017年1月期间在广西医科大学第一附属医院住院并已确诊为MG的56例病人的病例资料作为病例组,与MG组年龄匹配的没有自身免疫疾病的健康者的30例血清免疫相关检测指标资料作为对照组,比较两组的自身免疫抗体组合检测、T细胞亚群、CD4/CD8细胞计数、甲功和甲状腺抗体、肿瘤标记物、抗O及类风湿因子、空腹血糖、餐后2小时血糖、糖化血红蛋白等各指标。此外分析眼肌型和全身型MG的各免疫指标并进行统计分析。结果:MG组中衰减试验阳性率为48.21%(27/56)、疲劳试验阳性率89.29%(50/56)、新斯的明试验阳性率80.36%(45/56)。MG组的自身免疫抗体(X~2=7.471,P=0.006)、肿瘤标记物(X~2=8.205,P=0.004)阳性率高于对照组,合并甲状腺功能异常(X~2=8.958,P=0.003)、合并糖尿病(X~2=4.082,P=0.043)发生率高于对照组,而合并其他免疫疾病(X~2=2.247,P=0.134)、合并胸腺瘤(X~2=3.455,P=0.063)的发生率及ASO(X~2=0.542,P=1.000)、RF(X~2=1.097,P=0.295)的水平较对照组高,但无统计学意义。MG组的FT3(P=0.000)、非小细胞肺癌抗原(P=0.002)、神经元特异性烯醇化酶NSE(P=0.002)、餐后2小时血糖(P=0.036)、糖化血红蛋白(P=0.000)、CD4+T细胞(%)(P=0.003)、CD4/CD8(P=0.001)的水平较对照组高,而TSH(P=0.001)的水平较对照组低,差异具有统计学意义。全身型MG患者的抗自身免疫抗体中:抗RO-52抗体(X~2=0.659,P=0.417)、抗核抗体(Ig G型)ANA(X~2=1.12,P=0.578)和免疫荧光ANA:颗粒型(X~2=0.806,P=1.000)的阳性率及甲功异常(X~2=0.006,P=0.936)、衰减试验(X~2=0.009,P=0.926)、疲劳试验(X~2=8.485,P=0.107)和新斯的明试验(X~2=0.249,P=0.511)的阳性率均较眼肌型高,但无统计学意义。结论:MG发病与自身免疫抗体、肿瘤标记物、甲状腺功能异常、糖尿病相关,其中FT3、非小细胞肺癌抗原、NSE、餐后2小时血糖、糖化血红蛋白、CD4/CD8和CD4+T细胞(%)水平在MG患者中较高,而TSH水平较低。
[Abstract]:Objective: by analyzing the data of patients with myasthenia gravis (MGG) and the results of immune-related indexes, the purpose of this study was to explore the role of immune indexes in the pathogenesis of myasthenia gravis (MG). Methods: case data were collected from 56 patients who were hospitalized in the first affiliated Hospital of Guangxi Medical University from January 2012 to January 2017. The serum immune-related indexes of 30 healthy subjects without autoimmune disease matched with the age of MG group were used as the control group. The T cell subsets CD4 / CD8 cell count, thyroid antibody and thyroid antibody were detected by the combination of autoimmune antibodies in the two groups. Tumor markers, anti-O and rheumatoid factors, fasting blood glucose, 2 hours postprandial blood glucose, glycosylated hemoglobin and so on. In addition, the immune indexes of myometrial and systemic MG were analyzed and analyzed statistically. Results the positive rates of attenuation test and fatigue test were 48.21 / 27 / 56, 89.29 and 50 / 56, respectively. The positive rate of autoimmune antibody (XG) 27.471 (P0. 006) and tumor marker (XG 28.205P0.004) in the 80.36%(45/56).MG group was higher than that in the control group. The incidence of the patients with abnormal thyroid function was higher than that of the control group, but the incidence of the patients with other immune diseases was higher than that of the control group, and the incidence rate of the patients with Thymoma was 3.455P0.063), and the level of ASOOX20.542P1.000 was higher than that of the control group (P < 0.05), but the incidence of the disease was higher than that of the control group, and the incidence of the patients with the disease was higher than that of the control group, and the incidence of the disease was higher than that of the control group. However, no statistical significance was found in the levels of FT3P0. 000, P0. 002, NSEP0. 002, NSEP0. 002, P0. 036, P0. 000, P0. 000, CD4, CD8, P0. 001), but the levels of TSHP0. 001) were significantly higher in MG group than in the control group, but the levels of TSHP0. 001) were lower than those in the control group, but the levels of P0. 003- CD8 + P0. 001) were significantly lower than those in the control group (P < 0. 003, P < 0. 003), but the levels of TSHP0.001) were lower than those in the control group. The difference is statistically significant. The positive rate of anti-autoimmune antibodies in patients with systemic MG: anti RO-52 antibody X20.659P0. 417, antinuclear antibody ANAG X21.12P0. 578) and immunofluorescence Ana: ANAA: X2: 0. 806P1. 000) positive rate and the positive rate of thyroid dysplasia X20.006 / P0. 936, attenuation test X220.009 P0. 026, fatigue test X28.485P0. 107) and Xinsi test X2 0. 249P0. 11) The rate was higher than that of ocular muscle type. But there is no statistical significance. Conclusion the incidence of microglobulin is associated with autoimmune antibodies, tumor markers, thyroid dysfunction and diabetes mellitus. The levels of FT3, NSE, 2-hour postprandial blood glucose, glycosylated hemoglobin CD _ 4 / CD _ 8 and CD4 T cells are higher in MG patients. The level of TSH was lower.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R746.1

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