海洛因海绵状白质脑病的脑脊液和血清髓鞘碱性蛋白及其抗体检测及意义

Measurement and analysis of myelin basic protein and antibodies to myelin basic protein in serum and CSF of patients with heroin spongiform leukoencephalopathy

目的 通过对海洛因海绵状白质脑病 (HeroinSpongiformLeukoencephalopathy ,HSLE)患者血清和脑脊液髓鞘碱性蛋白 (myelinbasicprotein ,MBP)及其抗体 (Anti MBP)检测 ,探讨MBP与HSLE的关系。方法 采用酶联免疫吸附法 (ELISA)检测 1 8例HSLE患者、2 3例Heroin成瘾者 (吸毒但无HSLE临床症状者 ) ,1 7例多发性硬化患者(MS组 )、对照组 2 0例 (NC组 )的血清以及脑脊液 (CSF)中MBP及Anti MBP水平。结果 HSLE组、MS组CSF和血清MBP均值明显高于NC组和Heroin成瘾组 (P <0 .0 5) ,HSLE组与MS组CSF、血清MBP均值无统计学差异 (P >0 .0 5) ,Heroin成瘾组血清和CSFMBP均值与NC组间无统计学差异 (P >0 .0 5) ,4组血清和CSF的Anti MBP含量差异不显著 (P >0 .0 5)。结论 HSLE患者CSF及血清中MBP含量增高 ,MBP上升水平与髓鞘损伤程度有关 ,该病的髓鞘存在病理性损害 ,以及血脑屏障 (blood brainbarrier,BBB)的通透性改变。MBP检测可作为HSLE诊断及与海洛因成瘾者鉴别诊断的重要参数 。

Objective To investigate the relationship of myelin basic protein(MBP)and Heroin Spongiform Leukoencephalopathy(HSLE)by the measurement and analysis of MBP and Anti MBP levels in serum and CSF of patients with HSLE. Methods The levels of MBP and Anti MBP in CSF and serum of 18 patients with HSLE,23 patients with heroin addict without corresponding clinical symptoms(heroin addict),17 patients with multiple sclerosis(MS)and 20 normal controls(NC)were detected by enzyme linked immunosorbent assays(ELISA). Results The levels of MBP in CSF and serum of HSLE and MS patients were significantly higher than drug and NC groups( P <0.05). HSLE groups was increased slightly in CSF and serum but had no statistical difference to MS groups( P >0.05). Heroin addict groups were increased slightly in CSF and serum but had no statistical difference to NC groups( P >0.05). No statistically significant differences were found in serum and CSF Anti MBP values among four groups by the method( P >0.05). Conclusion The MBP levels in serum and CSF of HSLE patients increasing indicates that the myelin sheaths of CNS have severely pathological lesion and the high permeability of the blood brain barrier(BBB),and it might be related to the type and severity of cerebral white matter. The MBP level in serum and CSF will be an important parameter for diagnosis of HSLE and differentiation of heroin addict.