多发性硬化患者甲基强的松龙鞘内注射治疗前后血清尿酸水平变化及临床意义

The change of the serum levels of uric acid in multiple sclerosis patients before and after intrathecal injection of methylprednisolone and its clinical significance

目的探讨多发性硬化(MS)患者血清尿酸(UA)水平变化与病情活动性的关系。方法将58例MS急性期患者按主要治疗方法的不同分为鞘内注入甲基强的松龙组(鞘内注射MPS组)及大剂量甲基强的松龙冲击治疗组(MPS冲击组),测定MS急性期及治疗后缓解期血清UA值,并与其他非炎症性神经系统疾病患者作对照(对照组),同时对比治疗前后神经功能缺损评分。结果鞘内注射MPS组与MPS冲击组患者急性期血清UA水平显著低于缓解期及对照组,缓解期血清UA值虽低于对照组,但差异无统计学意义(P>0.05),伴随着UA水平回升,神经功能缺损评分降低,临床症状改善。结论血清UA水平变化与MS患者病情活动密切相关,UA可作为观察MS病情活动性及激素疗效的指标之一,血清尿酸水平的升高可能是一种评价治疗方法效果的重要指标。

Objective To investigate the relationship between serum levels of UA and the activity of disease in multiple sclerosis （MS） patients. Methods Fifty-eight MS patients were divided into two groups： intrathecal methylprednisolone group and methylprednisolone impact group. The serum levels of UA in relapse was compared with those in remission after intrathecal injection of methylprednisolone in MS patients, and with those in non- inflammatory neurological diseases（control group）. The degree of neurologic impairment were compared before and after methylprednisolone treatment. Results The serum levels of UA in replase of MS were significantly lower than those in remission and eontrol group. The clinical symptom and the nettrologic impairment got better with ascending of the serum levels of UA in MS patients. Conclusion Low serum levels of UA are closely related to the attack of MS. The serum levels of UA are helpful in judging the activity of MS and the theraputic effect of methylprednisolone treatment. Rasing the level of the serum uric acid may be an anticipant therapy.