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目的探讨外周血T淋巴细胞亚群凋亡在重症肌无力(MG)免疫发病机制中的作用及临床意义。方法采用流式细胞术结合免疫荧光抗体法测定了45例MG患者和40例正常对照组外周血CD4~+T淋巴细胞、CD8~+T淋巴细胞百分数及其凋亡状况,并对24例MG患者在应用糖皮质激素治疗后外周血T淋巴细胞亚群凋亡状况进行了观察。结果MG患者组外周血CD8~+T淋巴细胞百分率较正常对照组明显降低,CD4~+/CD8~+比值较正常对照组明显升高：MG患者组外周血CD4~+T淋巴细胞凋亡程度较正常对照组明显降低；MG患者外周血CD4~+T淋巴细胞凋亡程度与MG类型、预后密切相关：应用糖皮质激素治疗后MG患者外周血CD4~+T淋巴细胞凋亡程度明显增强。结论MG患者存在T淋巴细胞亚群的分布异常及CD4~+T淋巴细胞凋亡功能障碍,其凋亡程度可能与MG类型、预后密切相关,糖皮质激素对MG患者外周血CD4~+T淋巴细胞凋亡缺陷具有纠正作用。
Objective To investigate the role of peripheral blood T lymphocyte subsets apoptosis in the pathogenesis of myasthenia gravis (MG) immunity and its clinical significance. Methods The percentage of CD4 ~ + T lymphocytes and CD8 ~ + T lymphocytes in peripheral blood of 45 patients with MG and 40 normal controls were determined by flow cytometry and immunofluorescence antibody. The apoptosis of 24 MG Patients in the application of glucocorticoid treatment of peripheral blood T lymphocyte subsets apoptosis was observed. Results The percentage of CD8 ~ + T lymphocytes in peripheral blood of patients with MG was significantly lower than that of the control group, and the ratio of CD4 ~ + / CD8 ~ + was significantly increased in MG patients as compared with the normal control group. The levels of CD4 ~ + T lymphocyte apoptosis in MG patients The level of CD4 ~ + T lymphocyte apoptosis in peripheral blood of patients with MG was closely related to the type and prognosis of MG. The degree of apoptosis of CD4 ~ + T lymphocytes in peripheral blood of patients with MG was significantly increased after glucocorticoid treatment. Conclusion The abnormal distribution of T lymphocyte subsets and the dysfunction of CD4 ~ + T lymphocyte apoptosis exist in MG patients. The degree of apoptosis may be closely related with the type and prognosis of MG. The effect of glucocorticoid on CD4 ~ + T lymphocyte Apoptosis defects have a correcting effect.