兒童眼肌型重癥肌無(wú)力患者的AChRAb、IL12、補(bǔ)體成分和免疫球蛋白水平分析
發(fā)布時(shí)間：2019-04-10 14:15
【摘要】：目的 檢測(cè)兒童眼肌型重癥肌無(wú)力（OMG）患者血清IL12p40、AChRAb、C3、C4、IgG、IgM、IgA水平及IL12p40p70~+PBMC百分率，探討其在兒童眼肌型重癥肌無(wú)力發(fā)病中的作用。 采集2011年1月至2012年2月期間，在華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬同濟(jì)醫(yī)院神經(jīng)內(nèi)科門診確診的66例兒童眼肌型重癥肌無(wú)力患者及55例正常對(duì)照兒童的外周血，利用酶聯(lián)免疫吸附試驗(yàn)（ELISA）檢測(cè)外周血IL12p40及AChRAb水平;采用流式細(xì)胞技術(shù)檢測(cè)IL12p40p70~+PBMC百分率;通過(guò)同濟(jì)醫(yī)院檢驗(yàn)科獲得血清IgG、IgM、IgA、C3、C4結(jié)果，采用SPSS18.0軟件進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果 66例兒童OMG患者中，AChRAb陽(yáng)性48例，占73%，其中女性AChRAb陽(yáng)性率為69%，男性為76%。 兒童OMG組IL12p40p70~+PBMC百分率與正常兒童組無(wú)統(tǒng)計(jì)學(xué)差異。亞組分析顯示，無(wú)論是否使用糖皮質(zhì)激素（GC），AChRAb是否陽(yáng)性，該項(xiàng)指標(biāo)OMG患兒與正常兒童相比均無(wú)統(tǒng)計(jì)學(xué)差異，P0.05。 在甲狀腺及胸腺正常的OMG兒童中，無(wú)論是否使用GC，血清IL12p40水平均高于正常對(duì)照，未使用GC的患者IL12p40水平顯著高于使用GC的患者，P0.05。 在甲狀腺及胸腺正常且使用GC的OMG兒童中，無(wú)論AChRAb是否陽(yáng)性，血清C3、C4及IgM水平水平均顯著低于正常對(duì)照組，P0.05。無(wú)論AChRAb是否陽(yáng)性，兒童OMG患者血清中C3與C4水平呈正相關(guān)。 10歲以上甲狀腺及胸腺正常且使用GC的OMG兒童組血清IgG、IgA水平，與其正常對(duì)照組相比，無(wú)統(tǒng)計(jì)學(xué)差異，P0.05。 結(jié)論 大部分兒童OMG患者體內(nèi)AChRAb陽(yáng)性；L12p40參與了兒童OMG的免疫學(xué)發(fā)病機(jī)制；C3、C4可能主要通過(guò)補(bǔ)體經(jīng)典激活途徑發(fā)揮作用。中國(guó)的大部分兒童OMG和成人MG一樣，屬于自身免疫性疾病。
[Abstract]:Objective to investigate the role of serum IL12p40,AChRAb,C3,C4,IgG,IgM,IgA and IL12p40p70~ PBMC in the pathogenesis of ocular myasthenia gravis (OMG) in children with ocular myasthenia gravis (OMG). The peripheral blood samples were collected from 66 children with myasthenia gravis diagnosed from January 2011 to February 2012 in the Department of Neurology, Tongji Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology, and 55 normal children. The levels of IL12p40 and AChRAb in peripheral blood were measured by enzyme-linked immunosorbent assay (ELISA). Flow cytometry was used to detect the percentage of IL12p40p70~ PBMC and the results of serum IgG,IgM,IgA,C3,C4 were obtained by laboratory of Tongji Hospital. The results were analyzed statistically by SPSS18.0 software. Results among 66 children with OMG, 48 (73%) were AChRAb positive. The positive rate of AChRAb was 69% in female and 76% in male. There was no significant difference in the percentage of IL12p40p70~ PBMC between OMG group and normal group. Subgroup analysis showed that there was no significant difference between children with OMG and normal children regardless of whether glucocorticoid (GC), AChRAb was positive or not, P0.05. In OMG children with normal thyroid and thymus, the serum IL12p40 level of GC, was higher than that of normal controls, and the level of IL12p40 in non-GC patients was significantly higher than that in GC-treated children (P0.05). The levels of serum C _ 3, C _ 4 and IgM in OMG children with normal thyroid and thymic GC were significantly lower than those in normal controls (P0.05), regardless of whether AChRAb was positive or not. Whether AChRAb was positive or not, there was a positive correlation between C 3 and C 4 levels in children with OMG. There was no significant difference in serum IgG,IgA levels between normal thyroid and thymic OMG children over 10 years old and GC-treated children (P 0.05). Conclusion AChRAb is positive in most children with OMG, L12p40 is involved in the immunological pathogenesis of OMG in children, and C3, C4 may play a role in the classical activation of complement. Most Chinese children with OMG, like adult MG, are autoimmune diseases.
【學(xué)位授予單位】：華中科技大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R746.1
[Abstract]:Objective to investigate the role of serum IL12p40,AChRAb,C3,C4,IgG,IgM,IgA and IL12p40p70~ PBMC in the pathogenesis of ocular myasthenia gravis (OMG) in children with ocular myasthenia gravis (OMG). The peripheral blood samples were collected from 66 children with myasthenia gravis diagnosed from January 2011 to February 2012 in the Department of Neurology, Tongji Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology, and 55 normal children. The levels of IL12p40 and AChRAb in peripheral blood were measured by enzyme-linked immunosorbent assay (ELISA). Flow cytometry was used to detect the percentage of IL12p40p70~ PBMC and the results of serum IgG,IgM,IgA,C3,C4 were obtained by laboratory of Tongji Hospital. The results were analyzed statistically by SPSS18.0 software. Results among 66 children with OMG, 48 (73%) were AChRAb positive. The positive rate of AChRAb was 69% in female and 76% in male. There was no significant difference in the percentage of IL12p40p70~ PBMC between OMG group and normal group. Subgroup analysis showed that there was no significant difference between children with OMG and normal children regardless of whether glucocorticoid (GC), AChRAb was positive or not, P0.05. In OMG children with normal thyroid and thymus, the serum IL12p40 level of GC, was higher than that of normal controls, and the level of IL12p40 in non-GC patients was significantly higher than that in GC-treated children (P0.05). The levels of serum C _ 3, C _ 4 and IgM in OMG children with normal thyroid and thymic GC were significantly lower than those in normal controls (P0.05), regardless of whether AChRAb was positive or not. Whether AChRAb was positive or not, there was a positive correlation between C 3 and C 4 levels in children with OMG. There was no significant difference in serum IgG,IgA levels between normal thyroid and thymic OMG children over 10 years old and GC-treated children (P 0.05). Conclusion AChRAb is positive in most children with OMG, L12p40 is involved in the immunological pathogenesis of OMG in children, and C3, C4 may play a role in the classical activation of complement. Most Chinese children with OMG, like adult MG, are autoimmune diseases.
【學(xué)位授予單位】：華中科技大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R746.1
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