| Objective:By analyzing the changes in the levels of serum endogenous antioxidants uric acid(UA),bilirubin(BIL)and albumin(ALB)in patients with myasthenia gravis(MG),the correlation between serum antioxidant levels and MG in MG patients is further explored to provide a basis for clinical diagnosis and treatment.Methods:A total of 221 MG patients attending the Affiliated Hospital of Guizhou Medical University from January 2016 to December 2021 were selected,along with a total of 198 health checkups with similar sex and age ratios during the same period.Clinical data and laboratory test information such as serum uric acid,total bilirubin(TBIL),direct bilirubin(DBIL),indirect bilirubin(IBIL),albumin,urea,creatinine(Crea),alanine aminotransferase(ALT),and aspartate aminotransferase(AST)were collected from all study subjects.The information of QMG and MGFA-PIS scores of 69 follow-up patients were collected to analyze indicators of MG patients with different sexes,with or without thymoma,and different disease subtypes separately,as well as the correlation between ages,course of disease,BMI and serum uric acid,bilirubin and albumin of MG patients,and to further analyze the changes of serum uric acid,bilirubin and albumin before and after treatment and their correlation with QMGS of follow-up patients.Results:1.There was no significant difference between the MG group and the HC group in terms of male to female ratio,age,BMI,Urea,Crea,ALT and AST(P>0.05),and there was no significant difference between the above indicators of the MG group according to the presence or absence of thymoma and different disease subtypes,respectively(P>0.05).2.The serum levels of UA,TBIL,DBIL,IBIL,and ALB[(298.75183.87)μmol/L,(11.21±3.28)μmol/L,(3.72±1.19)μmol/L,(7.49±2.35)μmol/L,(42.29±5.97)g/L]were significantly lower in MG patients than those in the HC group[(328.63±62.48)μmol/L,(13.12±3.69)μmol/L,(4.50±1.24)μmol/L,(8.62±2.68)μmol/L,(44.67±3.23)g/L],the difference between the two groups has statistically significance(P<0.001).3.In the MG group,the serum levels of UA,TBIL,DBIL,and ALB in men were lower than those in male in HC group(P<0.05),but there was no significant difference in IBIL(P=0.074);in the MG group,the serum levels of UA,TBIL,DBIL,IBIL,and ALB of female were significantly lower than those of the HC group(P<0.05);among the MG patient groups,the serum levels of UA,TBIL,DBIL,IBIL,and ALB in female patients were significantly lower than those in male patients(P<0.01).4.There was no significant difference in serum levels of UA,TBIL,DBIL,IBIL,and ALB between MG patients with and without thymoma(P>0.05).5.In the patients with systemic MG,the serum levels of UA,TBIL,DBIL,IBIL,and ALB in both men and women were lower than those in the patients with ophthalmoplegia MG,and the difference was statistically significant(P<0.05).6.The serum levels of TBIL,DBIL,IBIL and ALB in MG patients had no correlation with age,course of disease and BMI(P>0.05),and serum UA level was negatively correlated with course of disease(P=0.015),but not with age and BMI.7.After treatment,the QMG score of patients was significantly decreased(P<0.001),and the serum levels of UA,TBIL,IBIL,and ALB were increased after treatment(P<0.05).8.In the follow-up patients,the serum levels of UA,TBIL,IBIL and ALB before treatment were negatively correlated with QMG score(P<0.05),and the serum levels of UA,and ALB were negatively correlated with QMG score after treatment(P<0.05).Conclusions:1.The serum UA、TBIL、DBIL、IBIL、ALB level in female patients with MG is lower than that in male patients,which may be one of the reasons why women are more prone to MG than men.Female are more likely to suffer from generalized MG than male.The serum antioxidant level of patients with ocular MG is greater than that of generalized MG.The decrease of serum levels of UA,BIL and ALB as well as female gender may be one of the risk factors leading to the conversion of ocular MG to generalized MG.2.There was no significant difference in serum levels of UA,BIL,and ALB between MG patients with and without thymoma,which may be due to the different pathogenesis of thymoma-related MG and the complex immune mechanism and apoptosis mechanism of thymoma.3.Serum UA,BIL,and ALB levels may be an objective indicator to evaluate the severity of disease in the acute phase in patients with MG,and are expected to be biomarkers for monitoring MG disease progression and assessing therapeutic effect. |
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