血清25-(OH)D、IL-6、CD8与NMOSD患者临床特点及治疗效果的关系

Relationship between serum^(2)5 - (OH) D, IL-6, CD8and the clinical characteristics and therapeutic effect of patients with NMOSD

目的探讨血清25-羟基维生素D[25-(OH)D]、白细胞介素-6(IL-6)、CD8与视神经脊髓炎谱系疾病(NMOSD)患者临床特点及治疗效果的关系。方法选取2019年1月至2021年12月在玉林市第一人民医院接受治疗的NMOSD患者92例作为观察组,同时随机选取健康体检者92名作为对照组。比较两组患者血清25-(OH)D、IL-6、CD8差异,同时分析观察组不同性别、年龄、体重指数、脊髓受累节段数、脊髓受累部位、扩展残疾状态量表(EDSS)评分差异。结果观察组血清25-(OH)D为(29.89±7.82)nmol/L,明显低于对照组,而IL-6和CD8分别为(25.05±6.68)pg/mL和(30.32±9.23)%,均明显高于对照组,差异均有统计学意义(P<0.05)。观察组脊髓受累节段数>5个的患者血清25-(OH)D为(25.28±7.25)nmol/L,明显低于脊髓受累节段数≤5个的患者,而IL-6和CD8分别为(28.65±7.02)pg/mL和(34.54±9.17)%,均明显高于脊髓受累节段数≤5个的患者,差异均有统计学意义(P<0.05)。观察组EDSS评分≥6.5分的患者血清25-(OH)D为(23.53±8.00)nmol/L,明显低于EDSS评分≤2.5分和3~6分患者,而IL-6和CD8分别为(30.86±5.60)pg/mL和(35.54±8.82)%,均明显高于EDSS评分≤2.5分和3~6分患者,差异均有统计学意义(P<0.05)。观察组EDSS评分3~6分的患者血清25-(OH)D为(28.65±8.10)nmol/L,明显低于EDSS评分≤2.5分患者,而IL-6和CD8分别为(25.02±5.34)pg/mL和(32.20±9.04)%,均明显高于EDSS评分≤2.5分患者,差异均有统计学意义(P<0.05)。观察组血清水通道蛋白4-抗体(AQP4-IgG)阳性和阴性表达患者血清25-(OH)D、IL-6、CD8比较,差异均无统计学意义(P>0.05)。血清25-(OH)D与脊髓受累节段数呈负相关(r s=-0.338,P<0.05),IL-6、CD8与脊髓受累节段数呈正相关(r s=0.336、0.401,P<0.05)。血清25-(OH)D与EDSS评分呈负相关(r s=-0.445,P<0.05),IL-6、CD8与EDSS评分呈正相关(r s=0.404、0.465,P<0.05)。与治疗前比较,观察组治疗后血清25-(OH)D有所升高,而IL-6和CD8有所降低,差异均有统计学意义(P<0.05)。结论血清25-(OH)D、IL-6、CD8与NMOSD患者脊髓受累节段数、病情严重程度有关。

Objective To investigate the relationship between serum^(2)5 hydroxyvitamin D[25-(OH)D],interleukin-6(IL-6),CD8 and clinical characteristics and therapeutic effect of patients with neuromyelitis optica pedigree disease(NMOSD).Methods A total of 92 patients with NMOSD who were treated in Yulin First People's Hospital from January 2019 to December 2021 were selected as the observation group,and 92 healthy people were selected as the control group,the differences in serum^(2)5-(OH)D,IL-6,CD8 between the two groups were compared.At the same time,the differences in gender,age,body mass index,number of involved segments of the spinal cord,involved parts of the spinal cord,and scores of the Extended Disability Status Scale(EDSS)in the observation group were analyzed.Results Serum^(2)5-(OH)D in the observation group was(29.89±7.82)nmol/L,which was significantly lower than that in the control group(P<0.05),while IL-6 and CD8 were(25.05±6.68)pg/mL and(30.32±9.23)%,respectively,which was significantly higher than that in the control group,the differences were statistically significant(P<0.05).In the observation group,the serum^(2)5-(OH)D in patients with more than 5 spinal cord involved segments was(25.28±7.25)nmol/L,which was significantly lower than the patients number of spinal cord involved segments≤5,while IL-6 and CD8 were(28.65±7.02)pg/mL and(34.54±9.17)%,respectively,which was significantly higher than the patients number of spinal cord involved segments≤5,the differences were statistically significant(P<0.05).The serum^(2)5-(OH)D of patients with EDSS score≥6.5 was(23.53±8.00)nmol/L,which was significantly lower than that of patients with EDSS score≤2.5 and 3-6,while IL-6 and CD8 were(30.86±5.60)pg/mL and(35.54±8.82)%,respectively,which was significantly higher than that of patients with EDSS score≤2.5 and 3-6,the differences were statistically significant(P<0.05).The serum^(2)5-(OH)D of patients with EDSS score of 3-6 in the observation group was(28.65±8.10)nmol/L,which was significantly lower than that of patients with EDSS score≤2.5,while IL-6 and CD8 were(25.02±5.34)pg/mL and(32.20±9.04)%,respectively,which was significantly higher than that of patients with EDSS score≤2.5,the differences were statistically significant(P<0.05).There was no statistically significant difference in serum^(2)5-(OH)D,IL-6,CD8 between patients with positive and negative aquaporin 4 antibody(AQP4 IgG)expression in the observation group(P>0.05).Serum^(2)5-(OH)D was negatively correlated with the number of spinal cord involved segments(r s=-0.338,P<0.05),while IL-6 and CD8 were positively correlated with the number of spinal cord involved segments(r s=0.336 and 0.401,P<0.05).Serum^(2)5-(OH)D was negatively correlated with EDSS score(r s=-0.445,P<0.05),while IL-6 and CD8 were positively correlated with EDSS score(r s=0.404 and 0.465,P<0.05),compared with that before treatment,serum^(2)5-(OH)D in the observation group increased after treatment,while IL-6 and CD8 decreased,the differences were statistically significant(P<0.05).Conclusion Serum^(2)5-(OH)D,IL-6,CD8 are related to the number of spinal cord segments involved and the severity of the disease in NMOSD patients.