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目的探讨糖皮质激素(GC)对新发病重症肌无力(MG)患者外周血白介素18(IL-18)、转化生长因子β-1(TGFβ-1)水平及临床疗效的影响。方法采用ELISA法检测26例新发病重症肌无力患者GC治疗前、治疗2月后和30名健康对照组血清IL-18、TGFβ-1水平,肌无力严重程度和临床疗效判定采用临床绝对和相对记分法。结果 MG患者外周血清IL-18、TGFβ-1水平均高于健康对照组(P<0.05);GC治疗2月后MG患者IL-18水平显著下降(t=8.92,P<0.01),TGFβ-1水平升高(t=-6.66,P<0.05);GC治疗前后预后差的全身型MG患者IL-18水平始终高于预后好的眼肌型MG患者(P<0.05),MG患者IL-18、TGFβ-1变化值与临床相对评分无明显相关性(r=0.301、r=-0.386,P>0.05)。结论 GC可通过抑制IL-18、提高TGFβ-1血清分泌水平而有效调节MG患者细胞免疫功能。
Objective To investigate the effect of glucocorticoid (GC) on the levels of interleukin 18 (IL-18), transforming growth factor β-1 (TGFβ-1) and clinical efficacy in patients with newly diagnosed myasthenia gravis (MG). Methods Serum levels of IL-18 and TGFβ-1 in 26 patients with newly diagnosed myasthenia gravis before and after treatment for 2 months and 30 healthy controls were determined by ELISA. The severity of myasthenia gravis and clinical efficacy were determined by clinical absolute and relative Scoring method. Results The serum levels of IL-18 and TGFβ-1 in MG patients were significantly higher than those in healthy controls (P <0.05). After 2 months of GC treatment, the levels of IL-18 in MG patients were significantly decreased (t = 8.92, (P <0.05). The levels of IL-18 in patients with systemic MG with poor prognosis before and after GC were always higher than those with good prognosis (P <0.05). The levels of IL- 18, there was no significant correlation between the change of TGFβ-1 and clinical relative score (r = 0.301, r = -0.386, P> 0.05). Conclusion GC can effectively regulate the cellular immune function of MG patients by inhibiting IL-18 and increasing the level of TGFβ-1 secretion.