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目的 研究重症肌无力 (myastheniagravis ,MG)患者胸腺的T、B淋巴细胞亚群表型 ,并分析与其外周血的相关性。方法 应用免疫荧光标记技术 ,经流式细胞仪分析 ,检测了 59例MG患者 ,包括 30例伴胸腺病变患者外周血的淋巴细胞亚群表型。另外 ,对 8例MG患者的胸腺和外周血经体外培养后进行检测。结果 ( 1)MG患者外周血辅助性T细胞 (Th ,CD4 +)异常增高 ,病程 6个月以内、伴胸腺增生者Th细胞均明显增多 ;( 2 )MG胸腺和外周血中经乙酰胆碱受体 (AChR)刺激后活化的Th细胞 (CD4 + CD2 5+)、CD5-B细胞 (CD5- CD19+)明显增多 ,且外周血CD5-B细胞与自身血清乙酰胆碱受体抗体 (AChRAb)滴度显著相关 (P <0 .0 1) ,胸腺摘除术 (Tx)后 ,MG外周血CD4 + CD2 5+、CD5- CD19+细胞均有所减少。结论 MG患者胸腺存在着异常的AChR特异应答性T、B淋巴细胞亚群表型 ,尤其以活化的Th细胞为著 ;CD5-B细胞的产生可能与MG密切相关。
Objective To study the phenotypes of T and B lymphocyte subsets in thymus of patients with myasthenia gravis (MG) and analyze their correlation with peripheral blood. Methods Immunofluorescence labeling technique was used to detect the phenotype of lymphocyte subsets in 59 patients with MG, including 30 patients with thymus lesions by flow cytometry. In addition, 8 cases of MG patients with thymus and peripheral blood after in vitro culture was detected. Results (1) The abnormal increase of T helper cell (Th, CD4 +) in peripheral blood of patients with MG was significantly increased within 6 months and thymocytes with thymus hyperplasia; (2) The proliferation of MG thymus and peripheral blood by acetylcholine receptor (CD4 + CD25 +) and CD5-B cells (CD5- CD19 +) activated by AChR were significantly increased, and CD5-B cells in peripheral blood were significantly correlated with AChRAb titers (P <0.01). After thymus excision (Tx), the number of CD4 + CD25 + and CD5- CD19 + cells in MG peripheral blood decreased. Conclusion There are abnormal AChR-specific T and B lymphocyte subsets phenotypes in thymus of MG patients, especially activated Th cells. The production of CD5-B cells may be closely related to MG.