【摘要】 目的研究重症肌无力(MG)患者在激素或免疫抑制剂干预治疗前后肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平的动态变化,探讨TNF-α和IL-6在MG发病机制中的作用。方法以符合诊断标准的30例各型MG患者(MG组)和20名正常人(对照组)为观察对象.在治疗前后进行肌无力评分并检测外周血单个核细胞TNF-α和IL-6水平变化。结果 MG组TNF-α和IL-6水平治疗前均明显高于对照组(P<0.01);治疗2周后较治疗前明显降低(P<0.01);全身型MG患者高于眼肌型患者,Ⅱb型高于Ⅱa型(P<0.05)。MG患眷治疗前后肌无力评分与TNF-α和IL-6水平均呈正相关(r=0.954、0.871、0.844、0.797,P<0.05),治疗前后评分差值与TNF-α和IL-6水平差值呈正相关(r=0.857、0.784,P<0.01)。结论 MG患者细胞免疫功能异常,肌无力轻重程度与TNF-α和IL-6分泌水平呈正相关,TNF-α和IL-6分泌水平变化可反映干预治疗疗效。更多还原

【Abstract】 Objective To investigate the dynamic changes of tumor necrosis factor-alpha (TNF-α)and interleukin-6 (IL-6) in patients with myasthenia gravis (MG), and to assess the cell immunity state of these patients in vitro. Methods Thirty cases of patients with MG and twenty normal controls were studied. Before and after the administration of corticosteroids or immunodepressant, the test of MG scores were taken, and the levels of the TNF-α and the IL-6 were measured by mean of radioimmunoassay in peripheral blood mononuclear cells among all patients. Results Compared with normal controls, the levels of TNF-α and IL-6 significantly increased (P<0.01) before treatment, and significantly decreased (P<0.01) after 2 weeks treatment in MG patients. The levels in systemic types of MG were higher than that in ocular types, in Ⅱ b types were higher than that in Ⅱ a types (P<0.05). The levels of TNF-α and IL-6 significantly decreased in patients with improved symptoms than those with ineffective ones (P<0.05). There were significant positive correlation between MG scores and the levels of TNF-α and IL-6 (P<0.05). Conclusions The cell immunity state of MG patients was abnormal. There were positive correlation between clinical symptom of patients and the levels of TNF-α and IL-6. The levels of TNF-α and IL-6 decreased after efficient treatment.更多还原