肌萎缩侧索硬化患者血清肌酐水平的研究

Evaluation of serum creatinine level in amyotrophic lateral sclerosis patients

目的 探讨散发性肌萎缩侧索硬化（sALS）患者血清肌酐（SCr）水平及其与临床指标的关系.方法 测定sALS、多系统萎缩（MSA）和紧张型头痛（TTH）各80例患者的SCr水平,分析sALS患者SCr水平与肌萎缩侧索硬化功能评分（ALSFRS-R）、用力肺活量（FVC）占预计值百分比、起病部位、病程和疾病进展速率之间的关系.结果 sALS组SCr水平低于MSA组和TTH组,差异有统计学意义[（60.86±16.80）μmol/L比（70.05±12.79） μmol/L和（66.97±14.14）μmol/L,P＜0.01];MSA组与TTH组SCr水平的差异无统计学意义（P =0.141）.sALS患者SCr水平与ALSFRS-R呈正相关（r =0.315,P=0.005）,而与FVC占预计值百分比、起病部位、病程和疾病进展速率无明显相关性（P值均＞0.05）.结论 SCr水平是sALS的一项重要生化指标,对监测疾病进展可能具有重要的作用.

Objective To investigate the serum creatinine （SCr） level in patients with sporadic amyotrophic lateral sclerosis （sALS） and to explore the relationship between the SCr level and the clinical characteristics.Methods A total of 80 patients with sALS,80 patients with multiple system atrophy （MSA） and 80 patients with tension-type headache （TTH） were enrolled in the study.The SCr levels were compared among the three groups.The association between the SCr level and the revised Amyotrophic Lateral Sclerosis Functional Rating Scale （ALSFRS-R）,the forced vital capacity （FVC） percentage of predicted （FVC% pred）,the site of symptom onset,the duration of disease and the rate of disease progression was evaluated in the sALS group.Results The SCr level was significantly decreased in the sALS group than the other two groups [（60.86 ± 16.80） μmol/L vs （70.05 ± 12.79） μmol/L and （66.97-± 14.14） μmol/L,P 〈 0.01].In the sALS group,the SCr level was positively correlated with the ALSFRS-R （r =0.315,P =0.005）,while no correlation was found between the SCr level and the FVC% pred,the site of symptom onset,the duration of disease and the rate of disease progression （all P 〉 0.05）.Conclusion The SCr level is an important biochemical index in the patients with sALS and might play an important role in monitoring the disease progression.