探讨视神经脊髓炎谱系疾病患者血清胱抑素C的水平与其临床特征的关系

Relationship between Serum Cystatin C Levels and Clinical Features in Patients with Neuromyelitisoptical Spectrumdisorders

目的探讨视神经脊髓炎谱系疾病(neuro myelitis optical spectrum disorders,NMOSD)患者血清胱抑素C(cystatinC,CysC)水平及同患者临床特征关系。方法选取2019年1月—2022年12月于广东省肇庆市第一人民医院神经内科就诊的50例NMOSD患者纳入NMOSD组,选取同期50名体检健康者纳入对照组。对比两组血清CysC水平、脑脊液白细胞数以及脑脊液蛋白;针对NMOSD组根据临床特征分成不同亚组,对比血清CysC测定结果;分析血清CysC水平与AQP4抗体滴度、脑脊液白细胞数、脑脊液蛋白含量、EDSS评分的相关性。结果NMOSD组血清CysC为(0.42±0.08)mg/L低于对照组(0.81±0.13)mg/L,差异有统计学意义(t=18.066,P<0.05);AQP4-IgG高滴度组CysC水平低于低滴度组,脑脊液白细胞数增高组血清CysC水平低于脑脊液白细胞数正常组,脑脊液蛋白含量增高组CysC水平低于脑脊液蛋白含量正常组,扩展残疾状态量表(EDSS)≥5分组血清CysC水平低于EDSS<5分组,差异有统计学意义(P<0.05)。血清CysC水平与AQP4抗体滴度、脑脊液白细胞数、脑脊液蛋白含量呈负相关(P<0.05),与EDSS评分呈正相关(P<0.05)。结论NMOSD患者血清CysC水平降低,血清CysC水平同患者AQP4抗体滴度、脑脊液白细胞数、脑脊液蛋白含量、神经功能预后等临床特征有密切关系。

Objective To investigate the relationship between serum cystatin C(CysC)level and clinical characteristics of patients with neuro myelitis optical spectrum disorders(NMOSD).Methods 50 NMOSD patients who visited the Department of Neurology at the First People′s Hospital of Zhaoqing City,Guangdong Province from January 2019 to December 2022 were selected and included in the NMOSD group.50 healthy individuals who underwent physical examinations during the same period were selected and included in the control group.Compared the levels of serum CysC,white blood cell count in cerebrospinal fluid,and cerebrospinal fluid proteins between the two groups.Divided the NMOSD group into different subgroups based on clinical characteristics and compared the results of serum CysC measurement.Analyzed the correlation between serum CysC level and AQP4 antibody titer,cerebrospinal fluid white blood cell count,cerebrospinal fluid protein content,and EDSS score.Results The serum CysC of the NMOSD group was(0.42±0.08)mg/L lower than that of the control group(0.81±0.13)mg/L,the difference was statistically significant(t=18.066,P<0.05).The CysC value in the high titer group of AQP4-IgG was lower than that in the low titer group,the serum CysC level in the group with increased white blood cell count in cerebrospinal fluid was lower than that in the group with normal white blood cell count in cerebrospinal fluid,the CysC value in the group with increased cerebrospinal fluid protein content was lower than that in the group with normal cerebrospinal fluid protein content,the serum CysC value of the group with EDSS≥5 points was lower than that of the group with EDSS<5 points,and the difference was statistically significant(P<0.05).The serum CysC level is negatively correlated with AQP4 antibody titer,cerebrospinal fluid white blood cell count,and cerebrospinal fluid protein content(P<0.05),but positively correlated with EDSS score(P<0.05).Conclusion Serum CysC level decreased in NMOSD patients,which was closely related to the clinical characteristics of AQP4 antibody titer,cerebrospinal fluid white blood cell count,cerebrospinal fluid protein content,neurological function prognosis and so on.