视神经脊髓炎星形胶质细胞损害与神经功能缺损的相关性分析
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摘要
目的:探讨水通道蛋白4抗体(AQP4-Ab)、载脂蛋白E(Apo E)、白介素-6(IL-6)在评价视神经脊髓炎星形胶质细胞损害与患者功能缺损关系中的临床价值。方法:选取2015年5月-2017年4月于本院神经内科进行诊治的116例急性发病期视神经脊髓炎(NMO)患者作为NMO组,选取同期本院门诊收治的紧张性头痛患者50例作为对照组。比较两组患者血清和脑脊液中AQP4-Ab、Apo E、IL-6水平,以及相关指标的Spearson相关性分析。结果:NMO组患者血清AQP4-Ab、IL-6水平均显著高于对照组,Apo E水平显著低于对照组(P<0.05)。NMO组患者脑脊液AQP4-Ab、IL-6水平均显著高于对照组,Apo E水平显著低于对照组(P<0.05)。经过Spearson相关性分析,NMO组患者脑脊液中AQP4-Ab与Apo E呈负相关关系,与IL-6呈正相关关系。经过Spearson相关性分析,NMO组患者脑脊液中AQP4-Ab、IL-6与EDSS评分呈正相关关系,Apo E与EDSS评分呈负相关关系。结论:NMO患者会伴随明显星形胶质细胞损害,其损害程度与患者神经功能缺损有关,且AQP4-Ab、APOE、IL-6水平在NMO疾病的发生发展过程中有重要作用。
Objective:To investigate the clinical value of aquaprin 4 antibody(AQP4-Ab),apolipoprotein E(Apo E) and interleukin-6(IL-6) in evaluating the relationship between astrocyte damage and functional impairment in patients with neuromyelitis optica(NMO).Method:From May 2015 to April 2017,116 patients with acute onset NMO treated in department of endocrinology of our hospital were selected as NMO group.50 patients with tension headache treated in our hospital during the same period were selected as the control group.The levels of AQP4-Ab,Apo E and IL-6 in serum and cerebrospinal fluid of two groups were compared,and Spearson correlation analysis of related indexes.Result:The serum levels of AQP4-Ab and IL-6 in NMO group were significantly higher than those in the control group,and the level of Apo E was significantly lower than that in the control group(P<0.05).The levels of AQP4-Ab and IL-6 in CSF of NMO group were significantly higher than those in control group,and the level of Apo E was significantly lower than that of the control group(P<0.05).Through Spearson correlation analysis,AQP4-Ab in CSF of patients in NMO group was negatively correlated with Apo E,and positively correlated with IL-6.Through Spearson correlation analysis,the cerebrospinal fluid AQP4-Ab,IL-6 and EDSS score in NMO group were positively correlated,and Apo E and EDSS scores were negatively correlated.Conclusion:NMO patients are associated with obvious astrocyte damage,and the extent of damage is related to neurological impairment,and the levels of AQP4-Ab,APOE and IL-6 play an important role in the pathogenesis and development of NMO.
Objective:To investigate the clinical value of aquaprin 4 antibody(AQP4-Ab),apolipoprotein E(Apo E) and interleukin-6(IL-6) in evaluating the relationship between astrocyte damage and functional impairment in patients with neuromyelitis optica(NMO).Method:From May 2015 to April 2017,116 patients with acute onset NMO treated in department of endocrinology of our hospital were selected as NMO group.50 patients with tension headache treated in our hospital during the same period were selected as the control group.The levels of AQP4-Ab,Apo E and IL-6 in serum and cerebrospinal fluid of two groups were compared,and Spearson correlation analysis of related indexes.Result:The serum levels of AQP4-Ab and IL-6 in NMO group were significantly higher than those in the control group,and the level of Apo E was significantly lower than that in the control group(P<0.05).The levels of AQP4-Ab and IL-6 in CSF of NMO group were significantly higher than those in control group,and the level of Apo E was significantly lower than that of the control group(P<0.05).Through Spearson correlation analysis,AQP4-Ab in CSF of patients in NMO group was negatively correlated with Apo E,and positively correlated with IL-6.Through Spearson correlation analysis,the cerebrospinal fluid AQP4-Ab,IL-6 and EDSS score in NMO group were positively correlated,and Apo E and EDSS scores were negatively correlated.Conclusion:NMO patients are associated with obvious astrocyte damage,and the extent of damage is related to neurological impairment,and the levels of AQP4-Ab,APOE and IL-6 play an important role in the pathogenesis and development of NMO.
引文
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[16]吴晓莉,何静杰,刘丽旭,等.视神经脊髓炎中抗水通道蛋白4抗体检测进展[J].神经损伤与功能重建,2013,8(1):62-65.
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[18]李敏,秦新月.多种方法检测视神经脊髓炎患者血清及脑脊液中水通道蛋白4抗体的临床应用[J].中国实验诊断学,2015,19(8):1261-1263.
[19]李婷,张大启,杨春生,等.血清水通道蛋白4抗体测定在视神经脊髓炎疾病谱中的意义[J].山东医药,2015,55(17):52-53.
[20]责羚,黄艳露,邱伟.视神经脊髓炎谱系疾病患者水通道蛋白4-Ig G临床意义及转归[J].临床内科杂志,2016,33(8):518-520.
[2]陈小玲,雷茵,唐玉兰,等.视神经脊髓炎星形胶质细胞损害与患者功能缺损的关系[J].实用医学杂志,2016,32(11):1767-1771.
[3]蒙晓珍,韦俊杰,唐玉兰,等.载脂蛋白E缺乏对小鼠星形胶质细胞损伤的影响[J].实用医学杂志,2016,32(11):1738-1741.
[4]杨程程,韦俊杰,唐玉兰,等.载脂蛋白E对EAE星形胶质细胞的影响[J].中风与神经疾病,2015,32(1):33-36.
[5]苏国华,冯丽萍,刘立海.抗水通道蛋白4抗体诊断视神经脊髓炎的临床价值[J].检验医学与临床,2014,11(24):3465-3466.
[6]Wei J,Zheng M,Liang P,et al.Apolipoprotein E and its mimetic peptide suppress Th1 and Th17 responses in experimental autoimmune encephalomyelitis[J].Neurobiol Dis,2013,56(8):59-65.
[7]Wang K C,Lee C L,Chen S Y,et al.Distinct serum cytokine profiles in neuromyelitis optica and multiple sclerosis[J].J Interferon Cytokine Res,2013,33(2):58-64.
[8]赵朔,徐全刚,魏世辉.视神经脊髓炎相关性视神经炎临床研究进展[J].中华眼底病杂志,2015,31(6):605-608.
[9]于鹭,汤可娜,仲星星,等.视神经脊髓炎谱系疾病患者中水通道蛋白4抗体与视神经损害的相关性[J].中国医科大学学报,2017,46(4):345-348.
[10]关新刚,苏维恒,郝峰,等.视神经脊髓炎患者血清中的AQP4抗体检测[J].中国实验诊断学,2013,17(12):2170-2172.
[11]Uzama A,Mori M,Kuwabara S.Cytokines and chemokines in neuromyelitis optica:pathogenetic and therapeutic implications[J].Brain Pathol,2014,24(1):67-73.
[12]厉向,童巧文,柯建明,等.血清水通道蛋白4抗体测定对视神经脊髓炎的诊断及预后判断价值[J].中国病理生理杂志,2014,30(11):1974-1979.
[13]袁静静,李泽宇,殷旭华.视神经脊髓炎的研究进展[J].中国神经免疫学和神经病学杂志,2013,20(2):135-137.
[14]程辰,黄德晖,吴卫平.视神经脊髓炎的治疗研究进展[J].临床神经病学杂志,2013,26(6):474-476.
[15]牛会丛,张星虎.视神经脊髓炎水通道蛋白4抗体分布特征及其与脑脊液寡克隆区带间关系的临床研究[J].中国现代神经疾病杂志,2014,14(9):806-811.
[16]吴晓莉,何静杰,刘丽旭,等.视神经脊髓炎中抗水通道蛋白4抗体检测进展[J].神经损伤与功能重建,2013,8(1):62-65.
[17]陈淑媛,吴哲,付贺飞,等.水通道蛋白4抗体对视神经脊髓炎的诊断价值[J].中国神经免疫学和神经病学杂志,2014,21(5):332-334.
[18]李敏,秦新月.多种方法检测视神经脊髓炎患者血清及脑脊液中水通道蛋白4抗体的临床应用[J].中国实验诊断学,2015,19(8):1261-1263.
[19]李婷,张大启,杨春生,等.血清水通道蛋白4抗体测定在视神经脊髓炎疾病谱中的意义[J].山东医药,2015,55(17):52-53.
[20]责羚,黄艳露,邱伟.视神经脊髓炎谱系疾病患者水通道蛋白4-Ig G临床意义及转归[J].临床内科杂志,2016,33(8):518-520.