摘要
目的研究脑脊液中轴索损伤标志物神经丝蛋白轻链（NFL）检测对视神经脊髓炎谱系疾病（NMOSD）诊断及预后的意义。方法收集2014年1月至2016年8月就诊于海军总医院的NMOSD患者61例作为试验组（NMOSD组），同期就诊的因其他疾病如神经症、偏头痛等行腰椎穿刺者24例作为正常对照组。收集NMOSD组临床、影像学资料及两组脑脊液标本，以酶联免疫吸附实验方法检测两组脑脊液中NFL浓度并进行比较。比较不同亚型的NMOSD患者脑脊液NFL水平，采用多元线性回归方法分析患者脑脊液中NFL浓度的影响因素。结果NMOSD组脑脊液NFL浓度[2 729.00（14 862.00） pg/ml]较正常对照组[299.50（308.00） pg/ml]明显升高，差异有统计学意义（进行以10为底的对数转换后行t检验，t＝8.588, P＝0.000）。NMOSD患者年龄（b＝0.017, P〈0.01）、扩展残疾状况量表评分（b＝0.078, P〈0.05）、病灶强化与否（b＝0.478, P〈0.01）对lg（NFL）有影响。性别、病程、血水通道蛋白抗体阳性率对NMOSD患者脑脊液中NFL浓度高低无明显影响。结论脑脊液NFL水平有助于评估NMOSD患者病情轻重及有无进展趋势。
ObjectiveTo discover the significance of neurofilament light （NFL） chain of cerebrospinal fluid （CSF）, an axonal injury biomarker, in diagnosis and prognosis prediction of neuromyelitis optica spectrum disorders（NMOSD）.MethodsSixty-one NMOSD patients and 24 other patients such as neurosis, migraine and so on, with lumbar puncture were enrolled as NMOSD group and normal control （NC） group from in and out patients of Department of Neurology of Navy General Hospital from January 2014 to August 2016. The clinical and neuroimaging features of NMOSD group and CSF samples of both groups were collected, and the NFL levels of CSF were measured by enzyme linked immunosorbent assay. The CSF NFL levels in different subtypes of NMOSD patients were compared, and the influence factors of the NFL levels in CSF were calculated by multiple linear regression analysis.ResultsThe NFL levels of CSF in NMOSD group （2 729.00（14 862.00） pg/ml） were significantly higher than that in NC group （（299.50（308.00） pg/ml, t=8.588, P=0.000; t test of NFL levels was performed after logarithmicly transforming based on 10）. There were no statistically significant differences of CSF NFL levels among optic neuritis, longitudinally extensive transverse myelitis and neuromyelitis optica. In NMOSD group, age （b=0.017, P〈0.01）, Expanded Disability Status Scale score （b=0.078, P〈0.05） and enhancement in gadolinium-magnetic resonance imaging （b=0.478, P〈0.01） were correlated with the NFL levels of CSF, while gender, courses of diseases and aquaporin 4 antibody in serum were not related to the NFL levels.ConclusionThe NFL levels of CSF are conducive to assess the severity and probable progress of NMOSD.
作者
彭丽君
钱海蓉
毛琳玲
夏德雨
雷霞
戚晓昆
Peng Lijun Qian Hairong Mao Linling Xia Deyu Lei Xia Qi Xiaokun(Department of Neurology, Navy General Hospital, Beijing 100048, China)
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2017年第6期430-434,共5页
Chinese Journal of Neurology
基金
首都临床特色应用研究重点项目（Z151100004015005）
