论文部分内容阅读
目的 观察全血灌流免疫吸附治疗重症肌无力的疗效。方法 以电鳗乙酰胆碱受体α亚单位Ta183 2 0 0段多肽为免疫源建立实验性自身免疫性重症肌无力动物模型 ,用以纤维素为载体、色氨酸为配基的吸附剂IM MG对实验兔进行全血灌流吸附治疗 ,比较治疗前后临床症状、抗体滴度、神经电生理功能的变化。结果 IM MG灌流治疗 2h ,能清除 (4 8 5 4± 2 4 7) %的致病抗体 ,肌无力症状显著改善 ;3、 5、10Hz重复神经电刺激实验复合动作电位衰减率明显恢复 (P <0 0 5 ) ,从治疗前的 (2 1 88± 7 2 4 ) %、(2 3 88± 7 4 2 ) %和 (2 5 75± 5 97) %依次恢复到 (16 0 0± 6 78) %、 (16 88± 7 4 2 ) %和 (17 5 0± 7 5 8) %。结论 IM MG全血灌流吸附治疗能有效清除重症肌无力动物体内的致病抗体 ,并相应改善肌无力症状 ,提高神经肌肉电传导功能 ,这很可能发展成为血液净化治疗重症肌无力危象的措施
Objective To observe the effect of whole blood perfusion immunosorbent therapy for myasthenia gravis. Methods The animal model of experimental autoimmune myasthenia gravis was established by using the polypeptide of Ta183 020 of the α subunit of acetylcholine receptor of eel and IM MG of the adsorbent with tryptophan as ligand Experimental rabbits were subjected to whole blood perfusion and adsorption treatment, and the changes of clinical symptoms, antibody titers and electrophysiological functions were compared before and after treatment. RESULTS: IMG perfusion treatment for 2h resulted in the removal of pathogenic antibodies (48,547 +/- 247)%. The symptoms of myasthenia gravis were significantly improved. At 3, 5 and 10 Hz repetitive electrical stimulation, the decay rate of compound action potential was significantly recovered (P <0 0 5), and then recovered to (16 0 0 ± 6) from (2188 ± 724)%, (2388 ± 742)% and (2575 ± 597)% before treatment 78%, (16 88 ± 7 4 2)% and (17 5 0 ± 7 5 8)%, respectively. Conclusion IM MG whole blood perfusion and adsorption therapy can effectively remove pathogenic antibodies in myasthenia gravis and improve the symptoms of myasthenia gravis and improve the neuromuscular electrical conduction function, which is likely to develop into a blood purifying treatment for myasthenia gravis crisis