肌萎缩侧索硬化患者的脑脊液蛋白及髓鞘碱性蛋白相关研究

The levels of cerebrospinal fluid protein and myelin basic protein in amyotrophic lateral sclerosis patients

目的探讨肌萎缩侧索硬化(ALS)患者的脑脊液蛋白、髓鞘碱性蛋白(MBP)水平及脑脊液蛋白与临床特征之间的关系。方法回顾性研究行腰穿查脑脊液的29例确诊ALS患者,检测其脑脊液蛋白及MBP水平,并按性别、年龄、病程、起病部位及临床功能评分〔肌萎缩侧索硬化功能分级量表(ALS-FRS)评分〕等不同临床特征分组,分析不同临床特征对脑脊液蛋白水平的影响。结果 29例ALS患者脑脊液蛋白水平为(0.43±0.15)g/L,其中脑脊液蛋白轻度增高患者9例(31%),最高为0.89g/L;不同性别〔男(0.42±0.15)g/L,女(0.45±0.18)g/L,t=0.501,P=0.620〕、年龄〔<60岁组(0.43±0.17)g/L,≥60岁(0.44±0.13)g/L,t=0.141,P=0.889〕、病程〔<1年组(0.37±0.11)g/L,≥1年(0.49±0.17)g/L,t=-2.23,P=0.054〕、起病部位〔球部起病组(0.38±0.11),肢体起病组(0.45±0.17),t=0.330,P=0.743〕、ALS-FRS评分〔>30分组(0.42±0.16)g/L,≤30分组(0.44±0.16)g/L,t=0.092,P=0.928〕分组间比较,脑脊液蛋白水平差异均无统计学意义。29例患者中13例进行了脑脊液MBP检测,MBP水平(1.66±0.78)nmol/L,13例患者MBP水平均增高,最高达3.39nmol/L。MBP水平与脑脊液蛋白水平无相关性(R=0.198,P=0.517)。结论 ALS患者脑脊液蛋白增高多见。部分ALS患者脑脊液MBP水平增高,但与脑脊液蛋白水平无相关性。

Objective To investigate the correlation between the clinical features and the levels of cerebrospinal fluid （CSF）protein and myelin basic protein （MBP）in patients with amyotrophic lateral sclerosis （ALS）. Methods Retrospective study was adopted among 29 hospitalized patients diagnosed as ALS, undergoing lumbar puncture. According to the different clinical characteristics of ALS,the CSF protein and MBP of the patients were detected. The patients were categorized according to gender,age,course of disease,the onset site,ALS-FRS,and the effects of clinical features on the CSF protein levels was discussed. Results CSF protein mildly increased in 9 patients （31%）. The average CSF protein level of 29 patients was （0.43 ±0.15） g/L. The highest level was 0.89 g/L.There were no significant differences in levels of CSF protein between the groups of the course of disease [〈1 year （0.37 ±0.11 ）g/L,≥1year （0.49 ±0.17 ）g/L,t = -2.23,P =0.054],disease onset [bulbar onset （0.38 ±0.11 ）,limb onset （0.45 ±0.17 ）,t =0.330,P =0.743 ],age [〈60 years old （0.43 ±0.17）g/L,≥ 60 years old （0.44 ±0.13 ）g/L,t =0.141,P =0.889 ]and gender [male （0.42±0.15）g/L,female （0.45 ±0.18）g/L,t=0.501,P =0.620],ALS-FRS [〉30 scores （0.42 ±0.16）g/L,≤30 scores （0.44±0.16）g/L,t =0.092,P =0.928]. The MBP levels were detected in 13 patients and all of them significantly increased. The highest level was 3.39 nmol/L （normal value≤0.55 nmol/L）,the average level was （1.66 ±0.78）nmol/L. There was no correlation between the levels of CSF protein and MBP （R=0.198,P =0.517）. Conclusions The CSF protein increasing is common in patients with ALS. The MBP levels increased in some of the ALS patients. It indicates that the MBP may play a role in the pathogenesis of ALS,but there is no correlation between MBP and CSF protein level.