内科

目的探讨重症肌无力（MG）患者外周血白介素-17（IL-17）、白介素-23（IL-23）的表达水平及其与发病的关系。方法将2015年7月至2017年6月我院收治的重症肌无力患者40例设为观察组，选取同期在我院进行健康体检的健康志愿者20例为对照组。根据病情轻重和病变的分布，按改良Osserman临床分型［5］将 MG患者分为眼肌型组（15例）和全身型组（25例）；按照胸腺病理组织学活检结果将患者分为胸腺正常组（16例）、胸腺增生组（11例）、胸腺瘤组（13例）。采用酶联免疫法检测比较观察组与对照组，眼肌型组和全身型组，胸腺正常组、胸腺增生组、胸腺瘤组患者的外周血IL-17、IL-23水平。结果观察组MG患者外周血IL-17、IL-23水平均显著高于对照组健康志愿者，差异有统计学意义（P＜0.05）。全身型MG患者血清IL-17、IL-23水平均显著高于眼肌型MG患者，差异有统计学意义（P＜0.05）。胸腺瘤组患者的IL-23水平显著高于胸腺正常组、胸腺增生组患者，胸腺瘤组患者的IL-17水平显著高于胸腺正常组患者，差异有统计学意义（P＜0.05）。结论重症肌无力患者的外周血清IL-17、IL-23水平表达异常升高，眼肌型和全身型MG患者，胸腺正常、胸腺增生、胸腺瘤MG患者的外周血IL-17、IL-23水平存在显著差异。

ObjectiveTo explore levels of IL-17 and IL-23 in the peripheral blood of patients with myasthenia gravis(MG) and its relationship with pathogenesis. Methods40 patients with MG treated in our hospital from July 2015 to June 2017 were selected and set as observation group, and another 20 healthy subjects who received medical check-up in the same period were selected and set as control group. According to the severity of the disease and the distribution of lesions, patients with MG were divided into ocular group (15 cases) and generalized group (25 cases) by modified Osserman classification. According to thymic histopathological biopsy results, patients with MG were divided into normal thymus group (16 cases), thymic hyperplasia group (11 cases), and thymoma group (13 cases). The serum IL-17 and IL-23 levels were detected with enzyme linked immunosorbent assay and compared among those above groups. ResultsThe serum levels of IL-17 and IL-23 in the observation group were significantly higher than those in the control group, the difference was statistically significant (P＜0.05). Serum IL-17 and IL-23 levels in patients with generalized MG were significantly higher than those in patients with ocular MG, the difference was statistically significant (P＜0.05). The level of IL-23 in thymoma group was significantly higher than that in normal thymus group and thymic hyperplasia group, the IL-17 level in thymoma group was significantly higher than that in the normal thymus group, the difference was statistically significant (P＜0.05). ConclusionThe expression levels of IL-17 and IL-23 in peripheral blood of patients with MG is abnormally elevated.Serum levels of IL-17 and IL-23 in patients with ocular MG and generalized MG significant difference, who have normal thymus MG, thymic hyperplasia MG and thymoma MG are also significant difference