神经精神狼疮患者脑脊液层粘蛋白透明质酸测定的临床意义

The level and clinical significance of laminin and hyaluronic acid in the cerebrospinal fluid of patients with neuropsychiatric lupus

目的探讨神经精神狼疮(N PLE)患者脑脊液(CSF)中层粘蛋白(LN)、透明质酸(H A)含量变化及临床意义。方法采用放射免疫法测定了系统性红斑狼疮(SLE)患者67例(其中N PLE31例,非NPLE36例)CSF中LN、H A水平;同时检测非SLE所致的脑血管病23例、正常对照组39例脑脊液中LA、H A含量。结果N PLE组CSF中LN、H A明显高于正常对照组、非NPLE-SLE组和非SLE所致的脑血管病组(P<0.01)。治疗有效的N PLE患者CSF中LN、H A较治疗前明显下降(P<0.05)。N PLE患者血清LN、H A与CSF中的LN、H A经直线相关分析,二者呈正相关(P<0.05)。CSF中LN、H A与CSF压力、蛋白、细胞数呈正相关(P<0.05)。结论SLE患者CSF中LN、H A的测定对临床诊断及预测N PLE提供了帮助。G SF中LN、H A含量的改变在一定程度上反映了SLE患者神经系统损害的程度,其动态监测可作为N PLE疗效和预后判断的参考指标。

Objective To investigate the level and clinical significance of laminin (LN) and hyalu-ronic acid (HA) in cerebrospinal fluid (CSF) of patients with neuropsychiatric lupus (NPLE). Methods The level of LN and HA in CSF in 31 cases of NPLE, 36 cases of no-NPLE SLE, 23 cases of no-SLE cerebrovascular disease and 39 normal controls were messured by radioimmunoassay method. Results The level of LN and HA in CSF of NPLE patients was higher than that of the no-NPLE, no-SLE cerebrovascular disease and normal controls (P<0.01). The level of LN and HA in CSF were decreased in NPLE patients in stable stage, when compared with that of before the treatment (P<0.05). Linear correlation analysis showed that the level of LN and HA in CSF was significantly positively correlated with the pressure, cells count, protein concentration of CSF (P<0.05). Conclusion The results suggest that the level of LN and HA in CSF of SLE patients and its change can indentify the injury of nervous system (in a certain degree). Therefore, understanding the changes of LN and HA in CSF is very important for the diagnosis and prognosis of NPLE.