14—3—3蛋白与吉兰-巴雷综合征早期诊断关系的研究

Relationship between 14-3-3 protein and early diagnosis of GuiUain-Barre Syndrome

目的观察吉兰-巴雷综合征（GBS）急性期脑脊液中是否存在14-3—3蛋白，探讨其与GBS早期诊断是否具有相关性。方法采用ELISAK汀方法检测40例GBS患者起病后3d内、第7天、第14天脑脊液14—3—3蛋白浓度，对照组为10例同期骨科手术患者及25例同期住院的其它神经系统疾病患者；并同时用罗氏P-800全自动生化分析仪检测脑脊液蛋白；观察早期GBS患者脑脊液中14—3—3蛋白含量变化及其与脑脊液蛋白是否具有相关性。结果GBS组在起病后3d内、第7天、第14天脑脊液中测得的14．3—3蛋白含量分别为（6．237±2．627）ng／mL、（8．369±3．003）ng／mL、（13．431±6．461）ng／mL；脑脊液蛋白含量分别为（0．308±0．113）g／k、（0．378±0．135）gm、（0．587±0．273）g／L：GBS组脑脊液14．3．3蛋白最早可于起病后20-48h出现，其含量在起病后第7天、第14天明显高于对照组，差异有统计学意义（P〈0．05）；GBS组脑脊液蛋白含量在起病后第14天明显高于对照组，差异有统计学意义（P〈0．05）；脑脊液14．3—3蛋白含量与脑脊液蛋白含量存在正相关关系（P〈0．05）。结论GBS早期脑脊液中存在14—3—3蛋白，其含量增高可使脑脊液蛋白量随之增高；用ELISAKiT方法检测脑脊液中14—3—3蛋白浓度可用于GBS的早期诊断。

Objective To observe the existence of 14-3-3 protein in cerebrospinal fluid of the early stage in patients with Guillain-Barre syndrome and explore its correlation with the early diagnosis of Guillain-Barre syndrome. Methods ELISA KiT was employed to measure the amount of 14-3-3 protein in 40 patients with Guillain-Barre syndrome of onset within 3 days, on the 7th day and 14th day as experimental group. We obtained 10 operative patients from department of orthopedics at the same term and 25 patients who had other diseases of the nervous system as control group. Roche P-800 fully automatic biochemical analyzer was used to test the protein of the cerebrospinal fluid, and observe the variation of 14-3-3 protein existed in tile cerebrospinal fluid and its correlation between 14-3-3 protein and protein in the cerebrospinal fluid. Results The concentration of 14-3-3 protein in the cerebrospinal fluid within 3 days, on the 7th day and 14th day were （6.237±2.627） ng/mL, （8.369±3.003） ng/mL and （13.431±6.461） ng/mL, respectively, and the concentration of protein in the cerebrospinal fluid within 3 days, on the 7th day and 14th day were （0.308±0.113） g/L, （0.378±0.135） g/L and （0.587± 0.273） g/L, respectively. The 14-3-3 protein appeared in the cerebrospinal fluid as early as 20-48 hours after onset and significantly higher on the 7th and 14th days of the onset of Guillain-Barre syndrome as compared to that of the control group （P〈0.05）; the protein in the cerebrospinal fluid significantly increased on the 14th days of the onset in the experimental group as compared with that in the control group （P〈0.05）; an obviously positive correlation was noted between 14-3-3 protein and protein in the cerebrospinal fluid in patients with Guillain-Barre syndrome （P〈0.05）. Conclusion In the early stage of Guillain-Barre syndrome, 14-3-3 protein exists in the cerebrospinal fluid and the amount of protein in the cerebrospinal fluid increased following the increment of 14-3-3 protein in the cerebrospinal fluid, Detection of 14-3-3 protein in the eerebrospinal fluid with ELISA KiT can be used in early diagnosis of Guillain-Barre syndrome.