视神经脊髓炎谱系疾病患者脑脊液蛋白水平与致残状况的相关性研究

The correlation between cerebrospinal fluid protein and disability status in patients with neuromyelitis optica spectrum disorders

目的探讨视神经脊髓炎谱系疾病(Neuromyelitis optica disorders,NMOSDs)患者脑脊液蛋白与临床致残状况的关系及其临床意义。方法回顾性分析2010年1月~2016年2月我院神经内科确诊的108例NMOSD患者临床与生化资料,根据临床扩展致残量表评分(Expanded disability status scale,EDSS)将患者分为独立行走受限与不受限组,并比较两组患者间的临床、生化特征;根据脑脊液蛋白值将患者分为脑脊液蛋白正常组与异常组,并比较两组间EDSS评分的变化;分析脑脊液蛋白与临床致残状况的相关性。结果独立行走受限组与不受限组之间患者年龄、二便障碍、外周血白细胞(WBC)、中性粒细胞比(N%)、脑脊液蛋白、脑脊液Ig G较有统计学差异(P<0.05);性别、病程、视力损害、AQP4抗体、24 h鞘内合成率、寡克隆带比较无统计学差异(P>0.05),两组不同脑脊液蛋白水平与患者EDSS值比较有统计学差异(T=3.13,P=0.002);脑脊液蛋白水平与独立行走受限呈正相关(r=0.286,P<0.01)。结论 NMOSD患者脑脊液蛋白值越高,患者致残发生的可能性越大,脑脊液蛋白有助于视神经脊髓炎谱系疾病患者致残状况的病情评估。

Objective To explore the correlation between the cerebrospinal fluid protein and disability status in patients with neuromyelitis optica spectrum disorders（ NMOSDs）. Methods Clinical and biochemical data of 108 patients with NMOSDs in department of neurology from January 2010 to February 2016 were retrospectively analyzed. According to Expanded disability status scale（ EDSS）,patients were divided into independent walking normally and limitedly groups,and their clinical and biochemical characteristics were compared between the two groups. According to level of cerebrospinal fluid protein,NMOSDs patients were divided into cerebrospinal fluid protein normal and abnormal groups,EDSS were compared among the two groups. The correlation between the cerebrospinal fluid protein and disability status was analyzed. Results Between the independent walking normally and limitedly groups,there were statistically significant differences in age of onset,sphincter dysfunction,peripheral blood leucocyte,neutrophil-lymphocyte ratio,cerebrospinal fluid protein and cerebrospinal fluid immunoglobulin G（ P〈0. 05）,there was no significant difference in gender,vision impaired,Aquaporin-4antibody and other clinical biochemical characteristics（ P〉0. 05）,and between the two groups by different levels of cerebrospinal fluid protein,there were statistically significant differences in EDSS（ T =- 3. 13,P = 0. 002）. Cerebrospinal fluid protein was positively correlated with the independent walking limitedly（ r = 0. 286,P〈0. 01）. Conclusion The incidence of disability increased accompany with the level of cerebrospinal fluid protein,and cerebrospinal fluid protein may helpful in monitoring of NMOSDs patients in the aspect of disability status.