Objective To investigate the clinical significance of serum anti-titin antibodies (titin-Ab) and anti-acetylcholine receptor antibodies (AChRAb) in patients with myasthenia gravis (MG). Methods To detect titin-Ab and AChRAb with enzyme linked immunosorbent assay (ELISA) in the sera from 90 cases of MG group and 30 cases of control group. Results The positive rates of titin-Ab and AChRAb (76. 7% , 54. 5%) in MG group were significantly higher than those of control group (y2 =41. 667 , P = 0. 000; y2 =21. 017, P = 0. 000). The sensitivities of titin-Ab and AChRAb in MG patients were 54. 5% and 76. 7% respectively. The sensitivity of parallel test was 89. 4%. The positive rates of titin-Ab were significantly higher in MG with thymoma (80.0%) and late-onset MG (72. 5%) subgroups than in the MG without thymoma (47. 1%, x2 = 6.771, P = 0. 009) and early-onset MG subgroups (40. 0%, x2 = 9.46, P=0. 002). The positive rates of both antibodies in generalized MG patients (69.2%, 90.4%) were higher than those in ocular MG patients (34.2%, x2=10.856, P = 0.001; 57.9%, x2 = 12.956, P≤0.000). There was no significant difference in the positive rate of titin-Ab (33.3%, 56.8%) and AChRAb (55.6%, 79%) between MG patients with and without hyperthyroidism (x2 = l. 797, P = 0. 19; x2=2. 491, P = 0. 063). Conclusions Titin-Ab and AChRAb can be used as indicators of the diagnosis of MG. Testing for a combination of titin-Ab and AChRAb gives higher sensitivity for the detection of MG than testing each antibody alone. The more severe the MG was, the higher positive rates of titin-Ab and AChRAb were. Titin-Ab and AChRAb titers were not correlated in MG patients.%目的 探讨重症肌无力(MG)患者血清titin抗体及乙酰胆碱受体(AChR)抗体与疾病临床特征的关系.方法 采用酶联免疫吸附试验对90例MG患者和30例对照组成员进行titin抗体和AChR抗体的检测并进行比较.结果 MG患者AChR抗体、Titin抗体阳性率(76.7％,54.5％)明显高于对照组(10％,6.7％)(x2＝41.667,P=0.000;x2=21.017,P＝0.000).titin抗体与AChR抗体检测MG的灵敏度分别为54.5％和76.7％,两种抗体并联试验灵敏度为89.4％.titin抗体在伴胸腺病变及晚发型MG患者中有较高阳性率,分别为80.0％和72.5％,明显高于非胸腺瘤组(47.1％,x2=6.771,P=0.009)和早发型MG患者(40％,x2＝9.46,P＝0.002).全身型MG患者titin抗体与AChR抗体阳性率(69.2％,90.4％)显著高于眼肌型MG(34.2％,x2＝10.856,P=0.001;57.9％,x2＝12.956,P≤0.000).甲亢组与非甲亢组MG患者titin抗体(33.3％,56.8％)与AChR抗体阳性率(55.6％,79％)差异性均无统计学意义(x2＝1.797,P=0.19;x2=2.491,P＝0.063).结论 MG患者病情越重,titin抗体与AChR抗体阳性率越高.Titin抗体及AChR抗体能作为诊断MG的指标,联合检测能提高MG诊断的灵敏.然而MG患者血清titin抗体与AChR抗体并无一致性关系.
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