MMF联合免疫球蛋白对MG患者CD4+T细胞亚群及细胞因子的影响

摘要

目的 研究吗替麦考酚酯(MMF)联合免疫球蛋白对重症肌无力(MG)患者CD4+T细胞亚群及细胞因子的影响.方法 将76例MG患者随机分组,对照组38例接受MMF治疗,联合组38例接受MMF+免疫球蛋白治疗,治疗6个月后,比较两组疗效.结果 联合组治疗总有效率94.74％,显著高于对照组的78.95％(P＜ 0.05);治疗后,两组肌无力疲劳程度(MWSS)评分、MG日常生活质量量表(MG-ADL)评分均显著降低,外周血CD4+CD25+、CD4+CD25+Foxp3+、CD4+IFN-y+细胞百分比显著上升,CD4+Th 17+细胞百分比显著下降;白介素2、]7(IL-2、IL-17)水平显著下降,白介素4、10(IL-4、IL-10)水平显著上升,且联合组下降或上升幅度大于对照组(P＜0.05);两组均无不良反应.结论 MMF联合免疫球蛋白治疗重症肌无力疗效显著,可明显改善患者肌无力疲劳程度,提升生活质量,改善免疫功能紊乱症状,安全有效.%Objective To study the impacts of Mycophenolate Mofetil (MMF) combined with immune globulin on CD4+T cell subsets and cytokines in patients with myasthenia gravis (MG).Methods A total of 76 patients with MG were selected and randomly divided into a control group and a combination group (n=38,respectively).The control group was treated with MMF and the combination group with MMF+immune globulin for six months.The effects between the two groups were compared.Results The overall response rate (ORR) in the combination group was 94.74％,which was significantly higher than that in the control group,which was 78.95％ (P ＜ 0.05);after the treatment,the muscle weakness severity score (MWSS) and MG activities of daily living (MG-ADL) scores in the two groups decreased significantly,the CD4+CD25+,CD4+CD25+Foxp3+,and CD4+IFN-γ+ cell percentage of peripheral blood (PB) increased greatly,and CD4+Th17+ cell percentage decreased greatly;the levels of interleukin 2 and 7 (IL-2 and IL-17) decreased significantly,the levels of IL-4 and IL-10 increased greatly,and the decrease in the combination group was greater than the increase in the control group (P ＜ 0.05).No adverse reactions occurred in the two groups.Conclusion MMF combined with immune globulin has significant effects in the treatment of MG,can dramatically improve the muscle weakness severity,quality of life and immune dysfunction in patients,and is safe and effective.