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目的研究骨髓间充质干细胞输注联合他汀类药物用于自身免疫性重症肌无力(MG)患者的临床效果。方法连续选择2013年2月—2014年5月来医院确诊的自身免疫性重症肌无力患者共20例,将其随机分为对照组和观察组各10例,对照组患者给予常规的激素和(或)免疫抑制剂治疗,观察组患者给予联合骨髓间充质干细胞和他汀类药物应用,对比2组患者的肌力Lennon评分、临床症状的综合功能进步评分包括进步程度、认识功能、运动功能、自理动作以及社会适应指标,及CD4~+T淋巴细胞表面CD28的表达和IL-4水平的差异性。结果随访约3个月后,2组患者的Lennon评分均降低,综合功能评分均升高,且观察组变化的更明显,差异有统计学意义(P<0.05)。进一步比较2组患者的综合功能评分,观察组患者的进步程度、认识功能、运动功能、自理动作以及社会适应评分均显著高于对照组,差异均有统计学意义(P<0.05)。治疗后2组患者的CD28分子和IL-4水平均降低,且观察组降低的更明显,差异有统计学意义(P<0.05)。结论骨髓间充质干细胞联合他汀类药物能够有效改善MG患者肌无力的临床效果,可能跟CD4~+T淋巴细胞表面CD28的表达和IL-4水平的降低有关。
Objective To study the clinical effect of bone marrow mesenchymal stem cells infusion combined with statins for patients with autoimmune myasthenia gravis (MG). Methods A total of 20 patients with autoimmune myasthenia gravis diagnosed in our hospital from February 2013 to May 2014 were randomly selected and randomly divided into control group and observation group of 10 cases. Patients in control group were given conventional hormone and ( Or immunosuppressive therapy. The observation group was given the combination of bone marrow mesenchymal stem cells and statins. The Lennon score of muscle strength was compared between two groups. The scores of comprehensive functional improvement of clinical symptoms included progress, cognitive function, motor function, Self-care and social adaptation as well as the difference of CD28 expression and IL-4 level on CD4 ~ + T lymphocytes. Results After about 3 months of follow-up, Lennon scores of both groups were decreased, comprehensive functional scores were increased, and the changes in the observation group were more obvious, the difference was statistically significant (P <0.05). Further comparison between the two groups of patients with comprehensive functional score, observation group patients progress, cognitive function, motor function, self-care movements and social adaptation scores were significantly higher than the control group, the difference was statistically significant (P <0.05). The levels of CD28 and IL-4 in both groups decreased after treatment, and the decrease in the observation group was more obvious with significant difference (P <0.05). Conclusion BMSCs combined with statins can effectively improve the clinical efficacy of myasthenia gravis in MG patients, which may be related to the decrease of CD28 expression and IL-4 level on CD4 ~ + T lymphocytes.