急性脊髓炎患者血清及脑脊液白蛋白免疫球蛋白及β-AP Tau蛋白的变化

Research on the change of the serum and CSF albumin,immunoglobulin and beta AP,Tau protein in patients with acute myelitis

目的 探讨急性脊髓炎患者血清及脑脊液白蛋白、免疫球蛋白及β-AP、Tau的变化.方法 选取神经内科2013年5月～2014年3月行脑脊液检查的患者67例,按是否为急性脊髓炎将患者分为疾病组35例和对照组33例,分别行血清及脑脊液微量清蛋白、免疫球蛋白及β-AP、Tau蛋白检测,并进行对比研究.结果 与对照组比较,疾病组患者SALB无明显差异（P＞0.05）;CALB和QALB明显升高,差异均有统计学意义（均P＜0.05）;SIgG、CIgG、IgG指数和IgG-syn均显著升高,差异均有统计学意义（均P＜0.05）;CSF-OBC阳性患者9例（28.1％）,两组间差异有统计学意义（P＜0.05）;血清β-AP、脑脊液β-AP、血清Tau蛋白和脑脊液Tau蛋白均无明显变化,差异均无统计学意义（均P＞0.05）.结论 急性脊髓炎患者早期就已经出现血脑屏障损害,SALB、CALB及QALB能作为判断血脑屏障损害的指标,并用于神经系统炎性疾病和非炎性疾病的鉴别诊断;急性脊髓炎患者存在免疫球蛋白指标异常,提示其疾病的发生与自身免疫相关;急性脊髓炎患者早期β-AP及Tau蛋白未出现明显异常,提示早期急性脊髓炎尚未出现神经功能损害,对判断疾病的进展和预后有积极作用.

Objective To study the change of the serum and CSF albumin, immunoglobulin and beta AP, Tau protein in patients with acute myelitis. Methods 67 patients were divided into disease group and the control group according to whether suffered from acute myelitis. Their albumin immunoglobulin and β-AP, Tau protein in serum and cerebrospinal fluid were examined and compared. Results Compared with control group, the SALB of the disease group had no significant differences （P〉0. 05）. The CAL~ and QALB increased significantly （P〈0.05）. SIgG index and IgG - syn CIkG , IgGwere significantly elevated（P〈0. 05）. There were 9 patients in the disease group with CSF- OBC positive, the positive rate is 28.1%. The difference between the two groups was statistically significant（P〈0.05）. There was no ob- vious change of β-AP and Tau protein in both serum and cerebrospinal fluid （P〉0.05）. Conclusion There is blood-brain barrier damage in patients with acute myelitis at the early stage. SALB, CALB and QALB can be used as judgment for the blood-brain barrier damage and also can be used to identify inflammatory diseases of nervous system and the differential diagnosis of inflammatory disease. There are abnormalities of immunoglobulin index in patients with acute myelitis which prompt their disease related with autoimmune. There are no obvious changes of β-AP and Tau protein in patients with acute myelitis at the early stage which prompt that there is no damage of nerve function.