中枢神经系统特发性炎性脱髓鞘疾病患者血清尿酸、同型半胱氨酸水平及其临床意义

Serum uric acid and homocysteine levels and their clinical significance in patients with idiopathic inflammatory demyelinating diseases of central nervous system

目的探讨中枢神经系统特发性炎性脱髓鞘疾病(IIDD)患者血清尿酸、同型半胱氨酸(Hcy)水平及其临床意义。方法选取51例IIDD患者(IIDD组),其中多发性硬化(MS)组39例、视神经脊髓炎(NMO)组12例,另选取40例同期住院的非脱髓鞘疾病患者为对照组。比较各组血清尿酸、Hcy水平及尿酸/Hcy比值,并分析其与MS组患者扩展残疾状态量表(EDSS)评分的相关性。结果MS组、NMO组、IIDD组的血清尿酸水平、尿酸/Hcy比值均低于对照组,而Hcy水平高于对照组(均P<0.05);MS组患者EDSS评分与Hcy水平呈正相关,而与尿酸水平、尿酸/Hcy值呈负相关(均P<0.05)。结论血清尿酸可能在IIDD中起到保护作用,而高Hcy水平可能起到促发IIDD的作用,尿酸/Hcy比例失衡可能是IIDD发病的重要环节及因素之一,尿酸/Hcy比值越低,可能预示发生IIDD的风险越高。

Objective To explore serum uric acid and homocysteine(Hcy)levels and theiRclinical significance in patients with idiopathic inflammatory demyelinating diseases(IIDD)of central nervous system.Methods Fifty-one patients with IIDD were selected,including 39 cases of multiple sclerosis(MS group),12 of neuromyelitis optica(NMO group),simultaneously,40 hospitalized patients with non-demyelinating diseases were selected as control group.Serum uric acid and Hcy levels and uric acid/Hcy ratio were compared between groups,and theiRcorrelation with Extended Disability Status Scale(EDSS)score was analyzed in the MS group.Results The MS,NMO and IIDD groups reported loweRserum uric acid level,loweRuric acid/HCY ratio,and higher Hcy level than the control group(all P<0.05).In the MS group,EDSS score positively correlated with Hcy level,but negatively correlated with uric acid level and uric acid/Hcy ratio(all P<0.05).Conclusion Serum uric acid plays a protective role in IIDD,while high Hcy level may play a role in developing IIDD,and uric acid/Hcy imbalance may be one of the important links and factors in the occurrence of IIDD.The loweRthe uric acid/Hcy ratio,the higheRthe risk of developing IIDD indicated potentially.