神经系统脱髓鞘性疾病抗氧化物质的变化及其意义

Changes of antioxidant substances in demyelinating diseases of nervous system and its nursing significance

目的观察血清胆红素(BIL)、尿酸(UA)、白蛋白(ALB)等抗氧化物质在神经系统脱髓鞘性疾病,如多发性硬化(MS)、视神经脊髓炎(NMO)、急性播散性脑脊髓炎(ADEM)及吉兰-巴雷综合征(GBS)中的变化,探讨抗氧化物质与脱髓鞘性疾病之间的关系。方法选取2015年1月至2018年12月在安徽省立医院住院的神经系统脱髓鞘疾病病人251例,中枢神经系统脱髓鞘性疾病病人146例,其中MS组95例,NMO组31例,ADEM组20例,周围神经系统脱髓鞘性疾病GBS病人105例;另外选取来自健康体检175例作为健康对照组。采集空腹>8 h的血液,采用酶定量法测定血清BIL、UA及ALB值,考虑到性别因素对于结果的影响,我们将各组分为男女两组分别进行比较。结果MS组(9.9±3.4)μm/L、NMO组(9.4±2.7)μm/L及GBS组(10.7±4.4)μm/L无论男女血清总胆红素水平均低于健康对照组(12.5±4.7)μm/L,且IBIL及TBIL差异有统计学意义,MS组[UA(225±77)μm/L,ALB(39.5±4.3)g/L]NMO组[UA(198±91)μm/L,ALB(36.7±3.7)g/L]、ADEM组[UA(206±77)μm/L,ALB(35.2±4.0)g/L]及GBS组[UA(259±92)μm/L,ALB(40.0±4.4)g/L]无论男女血清中UA和ALB水平均显著低于健康对照组[UA(303±93)μm/L,ALB(42.1±3.3)g/L]。结论血清BIL、UA及ALB等抗氧化物质在神经系统脱髓鞘性疾病中发挥了重要的保护性作用,临床工作中或许可以通过补充外源性抗氧化物质或其前体来防止疾病的发生发展。

Objective Observe anti-oxidation substances such as serum bilirubin(BIL),uric acid(UA)and albumin(ALB)in demyelinating diseases of the nervous system,such as multiple sclerosis(MS)and optic neuromyelitis(NMO).Changes in acute disseminated encephalomyelitis(ADEM)and Guillain-Barrésyndrome(GBS)explore the relationship between antioxidants and demyelinating diseases.Methods A total of 141 patients with central nervous system demyelinating diseases were enrolled,including 90 patients in the MS group,31 in the NMO group,20 in the ADEM group,105 patients with peripheral nervous system demyelinating disease GBS,and 175 from the health checkup as a normal control.The blood of the fasting>8 hours was collected,and the serum BIL,UA and ALB values were determined by enzyme quantitative method.Considering the influence of gender factors on the results,we divided the components into male and female groups.Results The serum bilirubin levels in MS(9.9±3.4)μm/L,NMO(9.4±2.7)μm/L and GBS(10.7±4.4)μm/L groups were lower than those in the normal control group(12.5±4.7)μm/L,and the differences in IBIL and TBIL were statistically significant.The serum BIL level in the ADEM group was slightly higher than that in the normal control group,and in the male group.The DBIL difference was statistically significant.The UA and ALB levels in the serum of males and females in MS group[UA(225±77)μm/L,ALB(39.5±4.3)g/L],NMO group[UA(198±91)μm/L,ALB(36.7±3.7)g/L],ADEM group[UA(206±77)μm/L,ALB(35.2±4.0)g/L]and GBS group[UA(259±92)μm/L,ALB(40.0±4.4)g/L]were significantly lower than those in normal control group[UA(303±93)μm/L,ALB(42.1±3.3)g/L].Conclusion Antioxidant substances such as serum BIL,UA and ALB play an important protective role in demyelinating diseases of the nervous system.It may be possible to prevent the occurrence and development of diseases by supplementing exogenous antioxidants or their precursors in clinical work.