摘要
目的探讨重症肌无力患者外周血程序性死亡受体-1(programmed death receptor-1,PD-1)和白细胞介素-23(interleukin-23,IL-23)水平及其与乙酰胆碱受体抗体(acetylcholine receptor antibodies,AChR-Ab)、病情严重程度相关性。方法选取重症肌无力44例作为重症肌无力组,健康体检者44例作为健康体检组,比较两组外周血单个核细胞中PD-1和血清IL-23水平,分析外周血PD-1和IL-23对重症肌无力的诊断价值,探讨重症肌无力患者外周血PD-1和IL-23与AChR-Ab、重症肌无力定量(quantitative myasthenia gravis,QMG)评分的相关性。结果外周血中PD-1与IL-23,重症肌无力组分别为(18.07±5.54)%和(29.51±4.81)pg/ml,高于健康体检组(10.67±2.50)%和(20.44±5.15)pg/ml,差异有统计学意义(P<0.01)。受试者工作特征曲线分析结果显示,外周血PD-1和IL-23诊断重症肌无力的曲线下面积分别为0.887和0.890,最佳截断值分别为15.07%和24.44 pg/ml,最佳截断值下诊断重症肌无力的特异度、敏感度、准确率和一致率分别为95.5%、72.7%、68.2%、84.1%和79.6%、84.1%、64.6%、81.8%。重症肌无力44例AChR-Ab为(1.29±0.33)nmol/L,QMG评分为(5.35±1.48)分。Pearson相关性分析结果显示,重症肌无力患者外周血PD-1和IL-23与AChR-Ab和QMG评分均呈正相关,相关系数分别为0.735、0.725和0.695、0.693。结论重症肌无力患者外周血IL-23和PD-1高于健康体检者;外周血IL-23和PD-1对重症肌无力有较好的诊断价值,且其与AChR-Ab、病情严重程度呈正相关。
Objective To investigate the expression level of programmed death receptor-1(PD-1)and interleukin-23(IL-23)in peripheral blood of patients with myasthenia gravis(MG)and their association with acetylcholine receptor antibodies(AChR-Ab)and severity of the disease.Methods Forty-four patients with MG were selected as the MG group,and 44 healthy subjects who underwent physical examination were selected as the healthy control group.The expression levels of PD-1 and serum IL-23 in the mononuclear cells of peripheral blood in the two groups were compared,and the diagnostic value of the peripheral blood PD-1 and IL-23 in MG was analyzed.In addition,the correlation of PD-1 and IL-23 in peripheral blood of MG patients with AChR-Ab and quantitative myasthenia gravis(QMG)was analyzed.Results The levels of PD-1 and IL-23 in peripheral blood in MG group were(18.07±5.54)%and(29.51±4.81)pg/ml,respectively,which were higher than those in the healthy control group[(10.67±2.50)%and(20.44±5.15)pg/ml](P<0.01).The results of receiver operating characteristic curve analysis showed that the areas under the curve for the diagnosis of MG by peripheral blood PD-1 and IL-23 were 0.887 and 0.890 respectively,and the best cut-off values were 15.07%and 24.44 pg/ml respectively.The specificity,sensitivity,accuracy and agreement rate of diagnosing MG under the value were 95.5%,72.7%,68.2%,84.1%and 79.6%,84.1%,64.6%,81.8%,respectively.The AChR-Ab of 44 cases of MG was(1.29±0.33)nmol/L,and QMG score was(5.35±1.48)points.The results of Pearson correlation analysis showed that peripheral blood PD-1 and IL-23 of patients with MG were positively correlated with AChR-Ab and QMG scores,and the correlation coefficients were 0.735,0.725 and 0.695,0.693,respectively.Conclusion The expression levels of IL-23 and PD-1 in peripheral blood of patients with MG are higher than those of healthy physical examinees.Peripheral blood IL-23 and PD-1 have good diagnostic value for MG,and their expression levels are positively correlated with AChR-Ab and the severity of the disease.
作者
袁慧姣
韩波
YUAN Hui-jiao;HAN Bo(Department of Laboratory,the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,China)
出处
《临床误诊误治》
CAS
2021年第3期63-68,共6页
Clinical Misdiagnosis & Mistherapy
基金
辽宁省教育厅科学技术研究项目(L201917)。
