重症肌无力合并胸腺病变患者血清乙酰胆碱受体抗体、肌联蛋白抗体和肌肉特异性酪氨酸激酶抗体的检测意义

摘要

目的：探究对重症肌无力合并胸腺病变的患者血清中乙酰胆碱受体(acetylcholine receptors,AchR)抗体、肌联蛋白(Titin)抗体和肌肉特异性酪氨酸激酶(muscle specific tyrosine kinase,MuSK)抗体的检测意义。方法选取我院收治的80例重症肌无力患者,根据是否存在胸腺病变分为胸腺病变组48例和非胸腺病变组32例,另取80例健康个体作为对照组,通过免疫酶联吸附试验对3组成员血清中 AchR 抗体、Titin 抗体和 MuSK 抗体进行检测并比较。结果重症肌无力患者血清 AchR 抗体和 Titin 抗体阳性率(76.3%,52.5%)均明显高于对照组(11.3%,5.0%)(P <0.05)；重症肌无力组及对照组患者血清 MuSK 抗体阳性率均为0,但前者血清中 MuSK 抗体水平明显高于后者(P <0.05)；AchR,Titin 两种抗体联合检测可明显提高检测重症肌无力的灵敏度；AchR 和 Titin 抗体在胸腺病变组中的阳性率明显高于非胸腺病变组(P <0.05)；全身型重症肌无力患者的血清 AchR 抗体和 Titin 抗体阳性率明显高于眼肌型(P <0.05)。结论 AchR 抗体和 Titin 抗体的阳性率与重症肌无力患者的病情相关,病情严重或合并胸腺病变可明显提高两者的阳性率,此外两者联合检测可提高诊断的灵敏度。而 MuSK 抗体在我国重症肌无力患者中的阳性率较低。%ABSTRACT:Objective To explore the significance of AchR antibody,Titin antibody and MuSK antibody in myasthenia gravis patients combined with thymic lesion.Methods A total 80 cases of myasthenia gravis patients treated in our hospital were selected.They were divided into thymic lesion group(n =48)and no-thymic lesion group (n = 32 ).Another 80 cases of healthy individuals were selected as control group.The positive rates of AchR antibody,Titin antibody and MuSK antibody were compared among three groups and different Osserman types. Results The positive rates of AchR antibody and Titin antibody of myasthenia gravis group(76.3%,52.5%)were higher than those of control group(1 1.3%,5.0%)(P <0.05).The positive rates of MuSK antibody of two groups were 0,but the level of myasthenia gravis group was higher than that of control (P <0.05).The detection sensitivity of myasthenia gravis could be improved using AchR antibody and Titin antibody.The positive rates of AchR antibody and Titin antibody of thymic lesion group were higher than those of no-thymic lesion group(P <0.05).The positive rates of AchR antibody and Titin antibody in generalized myasthenia gravis patients were higher than those in ocular myopathy myasthenia gravis patients(P <0.05).Conclusion The positive rates of AchR antibody and Titin antibody were related to the illness of myasthenia gravis.It can improve the detection sensitivity of myasthenia gravis using AchR antibody and Titin antibody.