横贯性脊髓炎患者水通道蛋白-4抗体的检测与临床特征分析

Detection and the significance of aquaporin- 4 antibody in patients with transverse myelitis

目的检测不同类型的横贯性脊髓炎(TM)患者水通道蛋白-4(AQP4)抗体,分析AQP4抗体的临床意义。方法研究对象为能获取标本检测AQP4抗体的TM患者。AQP4抗体通过间接免疫荧光的细胞法检测。结果共纳入TM患者92例,68例(73.9%)诊断为长节段横贯性脊髓炎(LETM),其余24例诊断为非LETM。LETM患者中39例(57.4%,39/68)AQP4抗体阳性,非LETM患者中2例(8.3%,2/24)AQP4抗体阳性。患者分成AQP4抗体阳性组与AQP4抗体阴性组,阳性组女性比例、LETM比例、脊髓炎复发率和功能残障评分均高于阴性组(P<0.05)。在亚群分析中,将68例LETM患者分成AQP4抗体阳性与AQP4阴性两组,可见阳性LETM组女性比例和脊髓炎复发率高于阴性LETM组(P<0.05)。Spearman相关性分析显示:AQP4抗体与女性(r=0.471,P<0.000 1)、LETM(r=0.433,P<0.000 1)及复发(r=0.560,P<0.000 1)相关。结论 AQP4抗体主要出现于LETM女性患者,抗体阳性患者比阴性患者更容易复发。

Objective To evaluate the significance of AQP4 antibody in patients with different types of transverse myelitis （TM）. Methods Patients with TM were included retrospectively between 2003 and 2014. AQP4 antibodies were detected by an indirect immunofluorescence assay employing HEK -293 cells transected with recombinant human AQP4. Results A total of 92 patients were included, among whom 68 patients with longitudinal extensive transverse my- elitis （LETM） and 24 patients with non - LETM. Positive AQP4 was observed in 39 LETM （57.4%, 39/68 ） and 2 n - LETM （8.3% , 2/24） patients. The female ratio, LETM ratio, relapsing case and EDSS were significantly higher in AQP4 positive patients than those in negative ones. In the patients with LETM, significantly more female and relapsing ea- ses were observed in AQP4 positive subjects than negatives. Correlation analysis showed that female, LETM and recurrent TM were significantly positively correlated with AQP4 antibody. Conclusion AQP4 antibody is mainly present in fe- males, and predicting high relapsing incidence.