CAJ | 학술논문

目的探讨血清可溶性细胞毒性T淋巴细胞相关抗原-4（CTLA-4）表达与福建地区重症肌无力（ myasthenia gravis ，MG）患者的相关性。方法 ELISA法检测福建地区80例MG患者（ MG患者分为激素未治疗组及激素治疗组，且激素治疗组进一步分为免疫抑制剂治疗组和胸腺切除组）和80例正常对照组血清可溶性CTLA-4（ sCTLA-4）水平。结果 MG激素未治疗组、激素治疗组的sCTLA-4均高于正常对照组[（6．03±3．58） ng/ml、（3．44±2．36） ng/ml vs （0．49±0．95） ng/ml]，它们之间的差别具有统计学意义（χ2＝100．67，P＜0．001）；其中激素治疗组sCTLA-4表达水平高于正常对照组（Z＝-9．03，P＜0．001），而 MG激素未治疗组sCTLA-4表达高于激素治疗组（Z＝-3．37，P＝0．001）；并且激素未治疗组激素治疗前后血清sCTLA-4水平差异有统计学意义（t＝3．10，P＝0．005）；胸腺切除术后sCTLA-4低于手术前（Z＝-2．21，P＝0．04），而免疫抑制剂治疗前后差异却没有统计学意义（Z＝-1．26，P＝0．21）。结论 sCTLA-4参与MG的发病机制，激素治疗、胸腺切除治疗减少sCT-LA-4表达。
목적탐토혈청가용성세포독성T림파세포상관항원-4（CTLA-4）표체여복건지구중증기무력（ myasthenia gravis ，MG）환자적상관성。방법 ELISA법검측복건지구80례MG환자（ MG환자분위격소미치료조급격소치료조，차격소치료조진일보분위면역억제제치료조화흉선절제조）화80례정상대조조혈청가용성CTLA-4（ sCTLA-4）수평。결과 MG격소미치료조、격소치료조적sCTLA-4균고우정상대조조[（6．03±3．58） ng/ml、（3．44±2．36） ng/ml vs （0．49±0．95） ng/ml]，타문지간적차별구유통계학의의（χ2＝100．67，P＜0．001）；기중격소치료조sCTLA-4표체수평고우정상대조조（Z＝-9．03，P＜0．001），이 MG격소미치료조sCTLA-4표체고우격소치료조（Z＝-3．37，P＝0．001）；병차격소미치료조격소치료전후혈청sCTLA-4수평차이유통계학의의（t＝3．10，P＝0．005）；흉선절제술후sCTLA-4저우수술전（Z＝-2．21，P＝0．04），이면역억제제치료전후차이각몰유통계학의의（Z＝-1．26，P＝0．21）。결론 sCTLA-4삼여MG적발병궤제，격소치료、흉선절제치료감소sCT-LA-4표체。
Objective To investigate the role of soluble cytotoxic T-lymphocyte associated antigen-4 (sCTLA-4) in the pathogenesis of myasthenia gravis (MG) in Fujian province.Methods A total of 80 patients with MG and 80 sex-and age-matched healthy controls were enrolled in the study .MG patients were divided into non-glucocorticoid treatment group and glucocorticoid treatment group , and the latter was further divided into immunosuppressive therapy group and thymusectomy group .Concentrations of sCTLA-4 in ser-ums from above mentioned groups were measured by enzyme-linked immunosorbent assay (ELISA).Results The concentrations of sCTLA-4 in both non-glucocorticoid treatment group and glucocorticoid treatment group were significantly higher than those in the healthy control group (6.03 ng/ml±3.58 ng/ml, 3.44 ng/ml± 2.36 ng/ml vs.0.49 ng/ml±0.95 ng/ml) (χ2=100.67, P<0.001), but sCTLA-4 concentrations in glu-cocorticoid treatment group were lower than those in non-glucocorticoid treatment group (Z=-3.37,P=0.001).With the treatment of glucocorticoid, the sCTLA-4 concentrations were reduced (6.03 ng/ml± 3.58 ng/ml vs.4.56 ng/ml±2.08 ng/ml;t=3.10, P=0.005), and the concentrations of sCTLA-4 were also decreased after thymusectomy therapy (3.86 ng/ml±2.53 ng/ml vs.2.59 ng/ml±2.37 ng/ml; Z=-2.21, P=0.04).However, there was no significant difference in the concentrations of sCTLA-4 before and after immunosuppressive drugs treatment (Z=-1.26,P=0.21).Conclusion The concentration of sCTLA-4 was increased in patients with MG , but with the treatment of glucocorticoid or thymusectomy it could be reduced .