The role of immunoglobulin and complement detection in myasthenia gravis
免疫球蛋白及补体检测在重症肌无力中的作用

摘要

目的 分析重症肌无力患者血清免疫球蛋白、补体水平，与患者的年龄、病程、和预后之间的关系。方法 选取时间段为2018.1月~2020.1月期间，因重症肌无力而入院接受治疗的患者100例，将其作为本次实验的主要观察对象，列为观察组，对其进行血清免疫球蛋白和补体水平的检测，并根据患者的年龄、病程和预后情况进行全面的分析。并选取40例健康患者作为本次实验的对照组，进行综合分析。结果 据本次实验分析，不同年龄段的重症肌无力患者其AChRAb、C3、IgG等免疫球蛋白及补体水平均有一定差异，其中以AChRAb、IgG指标变化最为明显，存在统计学意义，（P＜0.05）；同时，年龄段为19~49、≥50的重症肌无力患者与同阶段的健康者间有明显差异，（P＜0.05）。其次，不同病程时间的重症肌无力患者其AChRAb、C3、IgG等免疫球蛋白及补体水平均有一定差异，且随着疾病时间的延长，患者的IgM和IgA指标会逐渐的升高，而IgG则是呈现出逐渐降低的趋势，但对比不同病程组之间的免疫球蛋白和补体水平，数据之间并无明显差异，无统计学意义，（P＜0.05）。分析观察组重症肌无力患者的预后情况，好转患者82例，预后不良患者18例，且观察免疫球蛋白和补体水平的各项指标，预后好转组患者的AChRAb降低，其他C3、C4、IgG、IgM、IgA等指标均有明显增高，且数据间差异较为明显，（P＜0.05），存在统计学意义。结论 临床上对于重症肌无力患者的病情监测和治疗疗效评价，使用免疫球蛋白和补体水平的检测，能够为患者的病情变化提供可靠的参考，但并不能将其作为病情判断的唯一指标。

Abstract

Objective: To analyze the relationship between serum immunoglobulin and complement levels in patients with myasthenia gravis and their age, course of disease, and prognosis.
Methods: 100 patients who were admitted to the hospital due to myasthenia gravis during the period from January 2018 to January 2020 were selected as the main observation object of this experiment and listed as the observation group. Serum immunoglobulin and Detection of complement level, and a comprehensive analysis based on the patient's age, course of disease and prognosis. And 40 healthy patients were selected as the control group of this experiment for comprehensive analysis.
Results: According to the analysis of this experiment, the levels of AChRAb, C3, IgG and other immunoglobulins and complement in myasthenia gravis patients of different ages have certain differences. Among them, the changes of AChRAb and IgG indicators are the most obvious and have statistical significance, ( P <0.05); At the same time, there are significant differences between patients with myasthenia gravis aged 19-49, more than 50 and healthy people at the same stage (P <0.05). Secondly, patients with myasthenia gravis with different course of time have different levels of immunoglobulin and complement such as AChRAb, C3, IgG, and with the extension of the disease time, the patients' IgM and IgA indicators will gradually increase, while IgG It showed a gradual decreasing trend, but comparing the levels of immunoglobulin and complement between different disease groups, there was no significant difference between the data and no statistical significance (P <0.05). The prognosis of myasthenia gravis patients in the observation group was analyzed. 82 patients improved and 18 patients with poor prognosis. The indicators of immunoglobulin and complement levels were observed. The AChRAb of patients with improved prognosis decreased. Other C3, C4, IgG, IgM, IgA and other indicators have increased significantly, and the difference between the data is more obvious (P <0.05), which has statistical significance.
Conclusion  : The clinical monitoring and evaluation of the therapeutic effect of myasthenia gravis patients using immunoglobulin and complement levels can provide a reliable reference for the changes in the patient's condition, but it cannot be used as the only indicator for the judgment of the condition.