Objective To investigate the characteristics of serum anti-acetylcholine receptor antibody (AChR-Ab),antiTitin antibody (Titin Ab),anti Ryanodine receptor antibody (RyR-Ab) and antimusclespecific tyrosine kinase antibody (MuSK Ab) indifferent myasthenia gravis (MG) patient groups.Methods Serum AChR Ab,Titin-Ab,RyR-Ab,and MuSK Ab were detected with enzyme linked immunosorbent assay (ELISA) in 65 MG patients.Results Positive rates of serum AChR Ab,Titin-Ab,RyR Ab and MuSK-Ab were 47.70％,43.10％,46.200％ and 12.30％ respectively.There was no significant difference in AChR-Ab levels among different patient groups divided according to the length of disease course (P=0.305),but the levels of Titin-Ab,RyR Ab and MuSK-Ab significantly differed from each other (P=0.000,0.001,0.004,respectively).There was no significant difference between MG patients with or without thymoma for the positive rates and levels of all of the four antibodies (P＞0.05).There was significant difference among different MGFA subgroups for AChR-Ab levels (P=0.012),but not for the other three antibodies (P＞0.05).In detail,the AChR-Ab levels of type Ⅳ were significantly higher than type Ⅰ and Ⅱ.Conclusions The levels of Titin-Ab,RyR-Ab and MuSK-Ab is related to disease courses,and the level of AChR Ab is connected with severity of disease.%目的 探讨不同重症肌无力患者人群中血清抗乙酰胆碱受体(AChR)抗体、抗连接素(Titin)抗体、抗Rvanodine受体(RyR)抗体和抗肌肉特异性受体酪氨酸激酶(MuSK)抗体的表达特点.方法 采用酶联免疫吸附法(ELISA)检测65例重症肌无力患者血清AChR抗体、Titin抗体、RyR抗体和MuSK抗体水平,分析不同病程、胸腺情况以及美国重症肌无力协会(MGFA)临床分型MG患者各种抗体表达情况.结果 患者血清AChR抗体、Titin抗体、RyR抗体和MuSK抗体阳性率分别为47.70％、43.10％、46.20％和12.30％.不同病程MG患者中AChR抗体水平差异无统计学意义(P=0.305),Titin抗体、RyR抗体和MuSK抗体水平差异有统计学意义(分别P=0.000,P=0.001,P=0.004);胸腺瘤组和胸腺正常组间4种血清抗体阳性率和抗体水平差异无统计学意义(均P＞0.05);MGFA临床分型各亚组中AChR抗体水平差异有统计学意义(P=0.012),重度全身型(Ⅳ型)AChR抗体水平远高于眼肌型(Ⅰ型)和轻度全身型(Ⅱ型)(均P＜0.05),而Titin抗体、RyR抗体和MuSK抗体水平差异无统计学意义(均P＞0.05).结论 MG患者中Titin抗体、RyR抗体和MuSK抗体水平与病程有关,AChR抗体水平病情严重程度有关.
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