Effects of immunosuppressive agents on adult myasthenia gravis treated with video-assisted thoracoscopic surgery

Abstract

Objective To investigate the effect of immunosuppressive agents on video-assisted thoracoscopic surgery for the treatment of adult myasthenia gravis. Methods The patient with adult myasthenia gravis who underwent video-assisted thoracoscopic surgery in Qinhuangdao first hospital from August 2014 to March 2017 were selected as the subjects.According to the treament, they were divided into two groups: the control group and the observation group.The control group received immunosuppressive therapy after operation, and the observation group was given immunosuppressive treatment before operation.The postoperative recovery of the two groups was observed.The difference of CD4+ CD25+ regular T cells(Tregs) percentage and AchR-Ab concentration, clinical absolute score and adverse reaction rate between the two groups before and after treatment were compared. Results The postoperative critical care time and postoperative hospital stay in the observation group were shorter than those in the control group(t=4.158, 7.504, P<0.05); For the two groups of patients before operation, CD4+ CD25+ Tregs percentage and AchR-Ab concentration showed no difference.Three months after surgery, CD4+ CD25+ Tregs percentage in the observation gtroup was higher than those of the control group(t=-8.653, P<0.05). AchR-Ab level is lower in the observation group than that in the control group (t=6.604, P<0.05); There was no difference for clinical absolute score between the two groups.After 3 months, the clinical absolute score of the observation group was lower than that of the control group(t=8.952, P<0.05). There was no significant difference between the two for the groups in postoperative blood pressure elevation, blood glucose elevation, pulmonary infection, and the incidence of liver and kidney dysfunction(χ2=0.075, P=0.785). Conclusion Immunosuppressive therapy before and after operation has positive effect on adult myasthenia gravis treated with video-assisted thoracoscopic surgery.This treatment may have good application value. Key words: Immunosuppressive agents; Myasthenia gravis; Thoracoscopy; Catheterization