多发性硬化患者脑脊液组胺水平与EDSS评分的相关性分析

Correlation analysis of the level of cerebrospinal fluid histamine and EDSS score in patients with multiple sclerosis

目的分析多发性硬化(MS)患者脑脊液组胺水平与临床神经功能障碍程度的相关性。方法 2014年10月-2015年6月昆明医科大学第一附属医院神经内科和解放军昆明总医院神经内科收治MS患者46例(观察组),其中复发缓解型MS(RRMS亚组)患者29例,继发进展型MS(SPMS亚组)患者17例。另选择健康志愿者40例为健康对照组,采用酶联免疫吸附试验(ELISA)对2组脑脊液组胺水平进行检测及比较,并分析组胺水平与临床扩展致残量表评分(EDSS评分)的相关性。结果观察组患者脑脊液组胺水平明显高于健康对照组[(36.4±8.7)pg/ml vs.(8.9±3.7)pg/ml,t=2.86,P<0.01]。EDSS评分高于健康对照组[(3.8±1.1)分vs.(0.3±0.1)分,t=3.74,P<0.01]。RRMS亚组组胺水平低于SPMS亚组患者[(32.2±8.6)pg/ml vs.(40.6±5.1)pg/ml,t=2.09,P<0.05];EDSS评分显著低于SPMS亚组[(2.5±1.2)分vs.(4.9±1.4)分,t=2.82,P<0.01]。MS患者脑脊液组胺水平与EDSS评分呈正相关(r=0.66,P<0.01)。结论脑脊液组胺可以作为评价MS致残程度的实验室指标,且组胺及其受体可能成为治疗MS药物的潜在靶点。

Objective To analyze the correlation between the level of cerebrospinal fluid（CSF） histamine and the degree of clinical neurological dysfunction in patients with multiple sclerosis（MS）.Methods From October 2014 to June2015,46 MS patients who were admitted to Department of neurology,Kunming Medical University First Affiliated Hospital were enrolled as observation group,including the relapsing remitting MS（RRMS） subgroup of patients（29 cases） and secondary progressive MS（SPMS sub group） of 17 patients.40 cases of healthy volunteers were enrolled as healthy control group,by enzyme linked immunosorbent assay（ELISA）,CSF histamine levels of the two groups were detected and compared and analysis histamine levels and clinical extended disability scale score（EDSS） correlation.Results The histamine levels in the observation group were significantly higher than those in the healthy control group[（36.4 ±8.7） pg/ml vs.（8.9 ±3.7）pg/ml,t = 2.86,P〈0.01].EDSS score was higher than that of healthy control group[（3.8 ± 1.1） points vs.（0.3 ±0.1）points,t =3.74,P〈0.01].RRMS subgroup histamine levels below the SPMS subgroups of patients[（32.2 ±8.6） pg/ ml vs.（40.6 ±5.1） pg/ ml,t =2.09,P〈0.05];EDSS score was significantly lower than that of SPMS subgroup[（2.5 ±1.2） points vs.（4.9 ± 1.4） points,t = 2.82,P〈0.01].The levels of histamine in MS patients were positively correlated with EDSS score（r =0.66,P〈0.01）.Conclusion Cerebrospinal fluid histamine can be used as a laboratory index for evaluating the degree of disability in MS,and histamine and its receptors may be potential targets for the treatment of MS.