重症肌无力患儿免疫状态及静注免疫球蛋白的疗效

目的观察重症肌无力（ＭＧ）患儿机体免疫状态，比较静脉注射免疫球蛋白（ＩＶＩｇ）与免疫调节疗法 对ＭＧ的疗效。方法对８３例ＭＧ患儿分别于治疗前和缓解后，采用单项免疫扩散法检测血清免疫球蛋白（Ｉｇ），用 ＥＩＪＳＡ法检测乙酸胆碱受体抗体（ＡｃｈＲａｂ）和可溶性白细胞介素－２受体（ＳＩＬ－２Ｒ），以２４名健康儿童为对照组；并 对上述患儿中的６８例采用免疫调节疗法，２５例采用ＩＶＩｇ疗法。结果初发和复发的ＭＧ患儿ＩｇＧ、ＡｃｈＲａｂ、ＳＩＬ－２Ｒ 明显高于对照组（Ｐ＜０．００１），缓解后与对照组差异无显著意义（Ｐ＞０．０５）；ＩＶＩｇ治疗组和免疫调节治组疗缓解率均 为９２％，复发率ＩＶＩｇ组为８％，免疫调节组为１８％，两组比较差异有显著意义（Ｐ＜０．０５）。结论ＩｇＧ、ＡｃｈＲａｂ、ＳＩＬ－ ２Ｒ随ＭＧ的病情而变化，可作为预测ＭＧ病情的依据；ＩＶＩｇ疗法在降低复发率方面优于免疫调节疗法。

Immune States of Children with Myasthenia Gravis and Curative Effect ofIntravenous Ig on Them

Objective To observe the immune states of children with myasthenia gravis(MG) and compare the curative effects of intravenous Ig(IVIg)and immunoregulatory therapy on them.Methods The serum immnumoglobulin of 83 children with MG were detected by single immunodiffusion test before treatment and after remission, using 24 healthy children as control.The anti-acetylcholine receptor antibody(AchRab) and soluble IL-2 receptor(SLT-2R)of them were detected by ELISA. Of the 83 children,63 were treated by immunoregulatory therapy, and the rest 25 were treated with IVIg.Results The Ig,AchRab and SIL-2R levels of the children with primary and recurrent MG were significantly higher than those of control(P<0.001). However, after remission, no significant difference was observed between them(P>0.05). Both the remission rates of the children treated by IVIg and immunoregulatory therapy were 92%, but the recurrence rates of them were 8% and 18% respectively(P < 0. 05). Conclusion The Ig,AchRab and SIL-2R levels were changed with patients' conditions, so they could be used for the prediction of the state of illness. Compared with immunoregulatory therapy, treatment with IVIg was more effective in reducing recurrence rate.