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振幅整合脑电图联合血清HIF-1α、NFP在新生儿脑损伤中的诊断价值
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作者 胡娟娟 何晓娜 贾圆圆 《深圳中西医结合杂志》 2024年第8期78-81,I0004,共5页
目的:探讨振幅整合脑电图联合血清缺氧诱导因子–1α(HIF–1α)、神经丝蛋白(NFP)在新生儿脑损伤中的诊断价值。方法:选择2020年1月至2023年1月灵宝市第一人民医院收治的76例足月新生儿缺氧缺血性脑病(HIE)患儿作为观察组,根据脑损伤程... 目的:探讨振幅整合脑电图联合血清缺氧诱导因子–1α(HIF–1α)、神经丝蛋白(NFP)在新生儿脑损伤中的诊断价值。方法:选择2020年1月至2023年1月灵宝市第一人民医院收治的76例足月新生儿缺氧缺血性脑病(HIE)患儿作为观察组,根据脑损伤程度将其分为轻度损伤组(19例)、中度损伤组(37例)、重度损伤组(20例),行振幅整合脑电图(aEEG)监测,并检测血清HIF–1α、NFP水平。并选择同期50例健康新生儿作为对照组。采用受试者工作特征(ROC)曲线评估aEEG、HIF–1α、NFP及联合诊断新生儿脑损伤的价值。结果:观察组患儿血清HIF–1α、NFP水平明显高于对照组(P<0.05)。随着脑损伤程度加重,血清HIF–1α、NFP水平随之升高(P<0.05)。经ROC曲线分析,血清HIF–1α诊断新生儿HIE的曲线下面积(AUC)为0.683(95%CI:0.327~0.973),截断值为764.09 pg·mL^(-1)。血清NFP诊断新生儿HIE的AUC为0.771(95%CI:0.506~0.879),截断值为19.29 ng·mL^(-1),aEEG、血清HIF–1α和NFP联合诊断新生儿HIE的AUC为0.889(95%CI:0.627~0.995)。结论:联合aEEG和血清HIF–1α、NFP在诊断新生儿HIE上具有较高的潜能。 展开更多
关键词 新生儿缺氧缺血性脑病 振幅整合脑电图 缺氧诱导因子–1α 神经丝蛋白
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血清NFP、MMP-2联合mNGS在儿童中枢神经系统感染的临床价值 被引量:1
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作者 张晓蒙 苏秦 +3 位作者 杨光路 贾俊玲 朝鲁门其其格 李晓华 《国际检验医学杂志》 CAS 2023年第22期2739-2744,共6页
目的探讨血清中神经丝蛋白(NFP)及基质金属蛋白酶-2(MMP-2)联合宏基因组二代测序技术(mNGS)检测在儿童中枢神经系统(CNS)感染中的临床价值。方法选取2020年9月至2022年3月该院儿科收治的临床初步诊断为CNS感染的120例患儿,采用随机数表... 目的探讨血清中神经丝蛋白(NFP)及基质金属蛋白酶-2(MMP-2)联合宏基因组二代测序技术(mNGS)检测在儿童中枢神经系统(CNS)感染中的临床价值。方法选取2020年9月至2022年3月该院儿科收治的临床初步诊断为CNS感染的120例患儿,采用随机数表法将其分为传统方法组及mNGS组,每组60例,另选取同期该院儿科门诊未患CNS感染疾病的患儿60例为正常组。采用酶联吸附试验测定正常组、传统方法组及mNGS组患儿血清中NFP、MMP-2的表达水平,采用聚合酶链式反应(PCR)测定NFP mRNA、MMP-2 mRNA的表达水平;正常组、传统方法组及mNGS组检测患儿脑脊液中病原菌种类、比较阳性检测率、评价使用抗感染药物对检测率的影响及两组患儿的痊愈率;采用Kappa检测mNGS组血清中NFP、MMP-2的阳性率与mNGS阳性率在检测儿童CNS感染中的一致性;绘制受试者工作特征(ROC)曲线,采用二元Logistic回归计算联合预测因子,评价NFP、MMP-2、mNGS及联合预测因子在诊断儿童CNS感染性疾病的性能。结果传统方法组及mNGS组血清中NFP及MMP-2表达水平明显高于正常组,且传统方法组及mNGS组NFP mRNA及MMP-2 mRNA阳性率高于正常组,差异有统计学意义(P<0.05)。mNGS组病原菌检出总阳性率高于传统方法组及正常组,差异有统计学意义(P<0.05),使用抗菌药物治疗对mNGS检出率并无影响(P>0.05),mNGS组住院14 d后痊愈率高于传统方法组,差异有统计学意义(P<0.05)。mNGS组中NFP阳性率与mNGS组总阳性率之间一致性Kappa值为0.85,MMP-2阳性率与mNGS组总阳性率之间一致性Kappa值为0.92,两者差异均有统计学意义(P<0.05)。在调整年龄、性别等因素后,血清NFP每上升1 ng/mL,儿童CNS感染的风险则增加0.054倍(OR=1.054,95%CI:1.006~1.103,P<0.001),血清MMP-2每上升1 ng/mL,儿童CNS感染的风险则增加0.022倍(OR=1.022,95%CI:1.010~1.035,P<0.001),mNGS阳性率每上升1%,儿童CNS感染的风险则增加0.387倍(OR=1.387,95%CI:1.023~1.412,P<0.001)。结论联合应用血清中NFP、MMP-2与mNGS在预测儿童CNS感染中具有良好的效能,可用于儿童CNS感染的初步筛查,具有较高的临床价值。 展开更多
关键词 神经丝蛋白 基质金属蛋白酶-2 中枢神经系统感染 儿童 宏基因组二代测序
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Neurofilament proteins in axonal regeneration and neurodegenerative diseases 被引量:8
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作者 Haitao Wang Minfei Wu +4 位作者 Chuanjun Zhan Enyuan Ma Maoguang Yang Xiaoyu Yang Yingpu Li 《Neural Regeneration Research》 SCIE CAS CSCD 2012年第8期620-626,共7页
Neurofilament protein is a component of the mature neuronal cytoskeleton, and it interacts with the zygosome, which is mediated by neurofilament-related proteins. Neurofilament protein regulates enzyme function and th... Neurofilament protein is a component of the mature neuronal cytoskeleton, and it interacts with the zygosome, which is mediated by neurofilament-related proteins. Neurofilament protein regulates enzyme function and the structure of linker proteins. In addition, neurofilament gene expression plays an important role in nervous system development. Previous studies have shown that neurofilament gene transcriptional regulation is crucial for neurofilament protein expression, especially in axonal regeneration and degenerative diseases. Post-transcriptional regulation increased neurofilament protein gene transcription during axonal regeneration, ultimately resulting in a pattern of neurofilament protein expression. An expression imbalance of post-transcriptional regulatory proteins and other disorders could lead to amyotrophic lateral sclerosis or other neurodegenerative diseases. These findings indicated that after transcription, neurofilament protein regulated expression of related proteins and promoted regeneration of damaged axons, suggesting that regulation disorders could lead to neurodegenerative diseases. 展开更多
关键词 axonal regeneration nerve injury neurodegenerative diseases neurofilament protein post-transcriptional regulation REVIEWS
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Neuronal apoptosis and neurofilament protein expression in the lateral geniculate body of cats following acute optic nerve injuries 被引量:1
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作者 Feng Yu Shao ji Yuan Gang Sui Rong wei Zhang Zi sheng Liu Pei gang Lu 《Neural Regeneration Research》 SCIE CAS CSCD 2007年第10期577-581,共5页
The visual pathway have 6 parts, involving optic nerve, optic chiasm, optic tract, lateral geniculate body, optic radiation and cortical striatum area. Corresponding changes may be found in these 6 parts following opt... The visual pathway have 6 parts, involving optic nerve, optic chiasm, optic tract, lateral geniculate body, optic radiation and cortical striatum area. Corresponding changes may be found in these 6 parts following optic nerve injury. At present, studies mainly focus on optic nerve and retina, but studies on lateral geniculate body are few. OBJECTIVE: To prepare models of acute optic nerve injury for observing the changes of neurons in lateral geniculate body, expression of neurofilament protein at different time after injury and cell apoptosis under the optical microscope, and for investigating the changes of neurons in lateral geniculate body following acute optic nerve injury. DESIGN: Completely randomized grouping design, controlled animal experiment. SETTING: Department of Neurosurgery, General Hospital of Ji'nan Military Area Command of Chinese PLA. MATERIALS: Twenty-eight adult healthy cats of either gender and common grade, weighing from 2.0 to 3.5 kg, were provided by the Animal Experimental Center of Fudan University. The involved cats were divided into 2 groups according to table of random digit: normal control group (n=3) and model group (n=25). Injury 6 hours, l, 3, 7 and 14 days five time points were set in model group for later observation, 5 cats at each time point. TUNEL kit (Bohringer-Mannheim company )and NF200& Mr 68 000 mouse monoclonal antibody (NeoMarkers Company) were used in this experiment. METHODS: This experiment was carded out in the Department of Neurosurgery, General Hospital of Ji'nan Military Area Command of Chinese PLA between June 2004 and June 2005.① The cats of model group were developed into cat models of acute intracranial optic nerve injury as follows: The anesthetized cats were placed in lateral position. By imitating operation to human, pterion approach was used. An incision was made at the joint line between outer canthus and tragus, and deepened along cranial base until white optic nerve via optic nerve pore and further to brain tissue. Optic nerve about 3 mm was liberated and occluded by noninvasive vascular clamp for 20 s. After removal of noninvasive vascular clamp, the area compressed by optic nerve was hollowed and narrowed, but non-fractured. Skull was closed when haemorrhage was not found. Bilateral pupillary size, direct and indirect light reflect were observed. Operative side pupil was enlarged as compared with opposite side, direct light reflect disappeared and indirect light reflect existed, which indicated that the models were successful. Animals of control group were not modeled .② The animals in the control group and model group were sacrificed before and 6 hours, 1, 3, 7 and 14 days after modeling respectively. Lateral geniculate body sample was taken and performed haematoxylin & eosin staining. Immunohistochemical staining showed lateral geniculate body neurofilament protein expression, and a comparison of immunohistochemial staining results was made between experimental group and control group. Terminal deoxynucleo-tidyl transferase (TdT)-mediated dUTP-biotin nick end labeling (TUNEL) was used to label apoptotic cells in lateral geniculate body. MAIN OUTCOME MEASURES: Neuronal morphological change, neurofilament protein expression and cell apoptosis in lateral geniculate body following acute optic nerve injury. RESULTS: Twenty-eight involved cats entered the final analysis. ① Histological observation results: In the control group, cell processes were obviously found, which were few or shortening in the model group. ② Neuronal neurofilament protein expression: Cells in lateral geniculate body in the control group and at 6 hours after injury presented clear strip-shaped staining, and those at 7 and 14 days presented irregular distribution without layers and obviously decreasing staining intensity. The positive rate of neurofilament protein in lateral geniculate body in control group and 6 hours, l, 3, 7 and 14 days after injury was ( 10.22±0.42) %, (10.03±0.24) %, (9.94±0.14) %, (9.98±0.22) %, (8.18±0.34) % and (6.37±0.18)%, respectively. Positive rate of neurofilament protein in control group, at 6 hours, 1 or 3 days after injury was significantly different from that at 7 days after injury (P 〈 0.05); Positive rate of neurofilament protein in control group, at 6 hours, 1, 3 or 7 days after injury was significantly different from that at 14 days after injury (P 〈 0.05). It indicated that neuronal injury in lateral geniculate body was not obvious within short term after optic nerve injury, but obvious at 7 days after injury and progressively aggravated until at 14 days after injury.③ Neuronal apoptosis: TUNEL staining showed that neuronal apoptosis in lateral geniculate body appeared at 7 days after injury, and a Lot of neuronal apoptosis in lateral geniculate body was found at 14 days after injury. It indicated that neuronal injury in lateral geniculate body was related to apoptosis. CONCLUSION: In short term after optic nerve injury (within 7 days), nerve injury of lateral geniculate body is not obvious, then, it will aggravate with the elongation of injury time. The occurrence of neuronal iniury of lateral geniculate body is related to the apoptosis of nerve cells. 展开更多
关键词 optic nerve injuries lateral geniculate bodies apoptosis neurofilament proteins
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Oxidative phosphorylated neurofilament protein M protects spinal cord against ischemia/reperfusion injury
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作者 Haitao Wang Su Pan +2 位作者 Xiaoyu Yang Benqing Zhu Dalin Wang 《Neural Regeneration Research》 SCIE CAS CSCD 2014年第18期1672-1677,共6页
Previous studies have shown that neurofilament protein M expression is upregulated in the early stage of spinal cord ischemia/reperfusion injury, indicating that this protein may play a role in the injury process. In ... Previous studies have shown that neurofilament protein M expression is upregulated in the early stage of spinal cord ischemia/reperfusion injury, indicating that this protein may play a role in the injury process. In the present study, we compared protein expression in spinal cord tissue of rabbits after 25 minutes of ischemia followed by 0, 12, 24, or 48 hours of reperfusion with that of sham operated rabbits, using proteomic two-dimensional gel electrophoresis and mass spec- trometry. In addition, the nerve repair-related neurofilament protein M with the unregulated expression was detected with immunohistochemistry and western blot analysis. Two-dimen- sional gel electrophoresis and mass spectrometry showed that, compared with the sham group, upregulation of protein expression was most significant in the spinal cords of rabbits that had undergone ischemia and 24 hours of reperfusion. Immunohistochemical analysis revealed that neurofilament protein M was located in the membrane and cytoplasm of neuronal soma and axons at each time point after injury. Western blot analysis showed that neurofilament protein M expression increased with reperfusion time until it peaked at 24 hours and returned to baseline level after 48 hours. Furthermore, neurofilament protein M is phosphorylated under oxidative stress, and expression changes were parallel for the phosphorylated and non-phosphorylated forms. Neurofilament protein M plays an important role in spinal cord ischemia/reperfusion injury, and its functions are achieved through oxidative phosphorylation. 展开更多
关键词 nerve regeneration neurofilament protein M spinal cord injury ISCHEMIA/REPERFUSION proteomics phosphorylation NEUROPROTECTION NSFC grant neural regeneration
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Neurofilament 200 expression in a rat model of complete spinal cord injury following growth-associated protein-43 treatment
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作者 Yanping Duan Dongkui Zhang +5 位作者 Yingchun Ba Yun Yuan Jun Sun Dengli Fu Ran Zhang Jinde Wang 《Neural Regeneration Research》 SCIE CAS CSCD 2009年第11期827-831,共5页
BACKGROUND: Growth-associated protein-43 (GAP-43) expression in the nervous system has been demonstrated to promote neural regeneration, neuronal growth and development, as well as synaptic reconstruction. Neurofil... BACKGROUND: Growth-associated protein-43 (GAP-43) expression in the nervous system has been demonstrated to promote neural regeneration, neuronal growth and development, as well as synaptic reconstruction. Neurofilament 200 (NF200) expression could reflect degree of injury and repair in injured spinal axons. OBJECTIVE: To observe NF200 expression changes in a rat model of complete spinal cord injury following GAP-43 treatment and to explore the effects of GAP-43 following spinal cord injury. DESIGN, TIME AND SETTING: A randomized, controlled, animal experiment was performed at the Laboratory of Histology and Embryology of Kunming Medical University between March 2007 and October 2008. MATERIALS: GAP-43 and GAP-43 antibody were provided by Beijing Boao Biology, China; mouse anti-rat NF200 antibody was purchased from Chemicon, USA. METHODS: Female, 8-week-old, Sprague Dawley rats were randomly assigned into three groups following complete spinal cord injury, with 20 animals in each group: GAP-43 antibody, GAP-43, and model groups. In addition, each group was subdivided into four subgroups according to sampling time after modeling, Le., 3-, 5-, 9-, and 15-day groups, with 5 rats in each group. GAP-43 antibody or GAP-43 was injected into injury sites of the spinal cord, 5 μg/0.2 mL, respectively, twice daily for three consecutive days, followed by three additional days of injection, once daily. The model group did not receive any treatment following injury. MAIN OUTCOME MEASURES: NF200 expression in the damaged spinal area at different stages was detected by immunohistochemistry; lower limb motion function following injury was evaluated using the Basso, Beattie and Bresnahan (BBB) locomotor rating scale. RESULTS: NF200 expression was significantly reduced in the GAP-43 antibody group, compared with GAP-43 and model groups, at 3 and 5 days after spinal cord injury (P 〈 0.05). In addition, the model group expressed significantly less NF200 than the GAP-43 group (P 〈 0.05). BBB scores from the GAP-43 antibody and model groups were remarkably less than the GAP-43 group (P 〈 0.05). At 9 and 15 days of injury after drug withdrawal, NF200 expression was increased in the GAP-43 antibody group, and NF200 expression and BBB scores in the GAP-43 antibody and GAP-43 groups were significantly greater than in the model group (P 〈 0.05). In particular, the GAP-43 group exhibited greater BBB scores than the GAP-43 antibody group at day 9 (P 〈 0.05). CONCLUSION: GAP-43 promoted NF200 expression and recovery of lower limb function. Early administration of GAP-43 antibody produced reversible nerve inhibition, which was rapidly restored following withdrawal. 展开更多
关键词 spinal cord injury growth-associated protein-43 neurofilament 200 Basso Beattie and Bresnahan locomotor rating scale
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血清AQP4、NFL、BAFF水平与癫痫患儿认知功能的相关性及其对认知功能损害的评估价值
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作者 尚凤伟 王瑞丽 +1 位作者 李海珍 马振林 《海南医学》 CAS 2024年第10期1426-1430,共5页
目的探讨癫痫患儿血清水通道蛋白4(AQP4)、神经丝轻链蛋白(NFL)、B细胞活化因子(BAFF)水平与认知功能的相关性及其对认知功能损害的评估价值。方法选取2020年5月至2023年5月周口市中心医院收治的126例癫痫患儿作为研究对象,依据蒙特利... 目的探讨癫痫患儿血清水通道蛋白4(AQP4)、神经丝轻链蛋白(NFL)、B细胞活化因子(BAFF)水平与认知功能的相关性及其对认知功能损害的评估价值。方法选取2020年5月至2023年5月周口市中心医院收治的126例癫痫患儿作为研究对象,依据蒙特利尔认知评估量表(MoCA)分为认知损害组58例和认知正常组68例,同时选取同期体检正常儿童42例作为对照组。比较三组受检者的血清AQP4、NFL、BAFF水平;采用Pearson法分析血清AQP4、NFL、BAFF水平与国立医院癫痫发作严重程度量表(NHS3)、MoCA评分的相关性;采用多因素Logistic回归分析认知功能损害的影响因素,绘制受试者工作特征曲线(ROC)及曲线下面积(AUC)分析血清AQP4、NFL、BAFF水平对认知功能损害的评估价值。结果认知损害组患者的血清AQP4水平明显低于认知正常组和对照组,且认知正常组明显低于对照组,认知损害组患者的血清NFL、BAFF水平则明显高于认知正常组和对照组,且认知正常组明显高于对照组,差异均有统计学意义(P<0.05);认知损害组患者的NHS3评分为(14.25±3.75)分,明显高于认知正常组的(10.08±3.16)分,差异有统计学意义(P<0.05);经Pearson法分析结果显示,AQP4与MoCA评分呈正相关(r=0.528,P<0.05),与NHS3评分呈负相关(r=-0.429,P<0.05),而NFL、BAFF与MoCA评分呈负相关(r=-0.438、-0.501,P<0.05),NFL、BAFF与NHS3评分呈正相关(r=0.442、0.538,P<0.05);经多因素Logistic回归分析结果显示,全面性发作、发作频率升高、AQP4水平降低及NFL、BAFF水平升高均为认知功能损害的危险因素(P<0.05);经ROC分析结果显示,血清AQP4、NFL、BAFF、AQP4+NFL、AQP4+BAFF、BAFF+NFL、AQP4+NFL+BAFF评估认知功能损害的AUC分别为0.716、0.705、0.786、0.834、0.818、0.828、0.940,且AQP4+NFL+BAFF评估认知功能损害的AUC明显大于任意两项指标联合评估、单独指标评估(P<0.05)。结论癫痫患儿认知功能损害者血清AQP4水平降低,血清NFL、BAFF水平升高,其与癫痫发作严重程度密切相关,且为认知功能损害的影响因素,联合检测其水平对认知功能损害的评估具有临床意义。 展开更多
关键词 癫痫 认知功能 水通道蛋白4 神经丝轻链蛋白 B细胞活化因子 相关性
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血清神经丝轻链蛋白与认知障碍的相关性研究
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作者 邓长林 白向东 《宁夏医学杂志》 CAS 2024年第6期495-498,F0003,共5页
目的 研究包括轻度认知障碍(MCI)、阿尔茨海默病(AD)、血管性痴呆(VD)诊断在内的认知障碍疾病中血清神经丝轻链蛋白(NFL)水平测定的临床意义。方法 收集门诊及住院确诊认知功能障碍的住院患者,根据纳入及排除标准分为MCI组47例、 AD组4... 目的 研究包括轻度认知障碍(MCI)、阿尔茨海默病(AD)、血管性痴呆(VD)诊断在内的认知障碍疾病中血清神经丝轻链蛋白(NFL)水平测定的临床意义。方法 收集门诊及住院确诊认知功能障碍的住院患者,根据纳入及排除标准分为MCI组47例、 AD组46例、 VD组43例及在门诊体检的健康人群45例作为正常对照组,其中AD组及VD组根据病情严重程度分为轻度组及中重度组,所有患者在确诊后当天进行认知功能评价,在确诊后第二天清晨行血清NFL检查。结果 4组之间的血清NFL水平的比较差异有统计学意义(P<0.05);组间两两比较中,MCI组和AD组的血清NFL水平之间的比较差异无统计学意义(P>0.05);亚组分析中AD组轻度痴呆患者与中重度痴呆患者的血清NFL水平的比较,中重度痴呆患者的血清NFL水平高于轻度痴呆患者,差异有统计学意义(P<0.05);VD组轻度痴呆患者与中重度痴呆患者的血清NFL水平的比较,中重度痴呆患者的血清NFL水平高于轻度痴呆患者,差异有统计学意义(P<0.05)。结论 血清NFL水平检测在临床中可以作为AD及VD早期诊断和病情严重程度判断的外周血生物标志物。 展开更多
关键词 血清神经丝轻链蛋白 认知障碍 血管性痴呆
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神经丝轻链蛋白与2型糖尿病认知功能障碍关系的研究进展 被引量:1
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作者 曹晴祎 田毅 王金浓 《中国医学科学院学报》 CAS CSCD 北大核心 2024年第1期98-103,共6页
2型糖尿病(T2DM)代谢异常可造成中枢神经系统的损害,从而导致认知功能下降。神经丝轻链蛋白(NFL)作为神经元轴突损伤的血液标志物,与认知功能障碍发病显著相关,并受肾功能的影响,可通过炎症反应、血脑屏障的破坏、小胶质细胞和神经元的... 2型糖尿病(T2DM)代谢异常可造成中枢神经系统的损害,从而导致认知功能下降。神经丝轻链蛋白(NFL)作为神经元轴突损伤的血液标志物,与认知功能障碍发病显著相关,并受肾功能的影响,可通过炎症反应、血脑屏障的破坏、小胶质细胞和神经元的交互作用、Tau蛋白磷酸化等参与T2DM认知功能障碍的发生发展。本文将对NFL参与T2DM认知障碍发生发展的病理生理机制和NFL与T2DM肾功能的相关性进行综述,为早期诊断和治疗T2DM患者认知功能障碍提供依据。 展开更多
关键词 2型糖尿病 认知功能障碍 神经丝轻链蛋白
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抗神经丝重链抗体相关脑炎一例并文献复习
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作者 程婧 张炜炜 +3 位作者 周勤明 孟环宇 何璐 陈晟 《中国现代神经疾病杂志》 CAS 北大核心 2024年第5期359-364,共6页
目的 报告国内首例抗神经丝重链抗体相关脑炎病例,并复习相关文献,总结抗神经丝重链抗体相关脑炎的临床特征。方法与结果 1例63岁女性抗神经丝重链抗体相关脑炎患者临床表现为认知功能障碍、反复癫痫发作、失语;头部MRI显示双侧额顶叶... 目的 报告国内首例抗神经丝重链抗体相关脑炎病例,并复习相关文献,总结抗神经丝重链抗体相关脑炎的临床特征。方法与结果 1例63岁女性抗神经丝重链抗体相关脑炎患者临床表现为认知功能障碍、反复癫痫发作、失语;头部MRI显示双侧额顶叶多发异常信号,部分脑回略肿胀,幕上脑室系统扩张,脑萎缩以双侧颞叶、海马为甚;18F-DPA714 PET/MRI显示额颞顶枕叶多脑区局灶性摄取异常增高,提示神经炎症;脑电图呈频繁痫样放电;脑脊液白细胞计数和葡萄糖升高,血清和脑脊液自身免疫性脑炎相关抗体阴性,血清TBA法显示小脑神经丝样荧光包绕浦肯野细胞,进一步检测抗神经丝蛋白抗体,血清抗神经丝重链抗体强阳性(1∶1000)。临床诊断为抗神经丝重链抗体相关脑炎,予静脉注射免疫球蛋白和甲泼尼龙治疗,预后改善。结论 抗神经丝重链抗体相关脑炎临床罕见,临床表现多样,早期诊断与鉴别诊断困难,早期予以免疫治疗对预后至关重要。 展开更多
关键词 脑炎 自身免疫疾病 神经微丝蛋白质类 自身抗体 脑脊髓液
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阿尔茨海默病患者神经丝轻链蛋白水平与临床特点相关性分析
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作者 王露露 周敏 +1 位作者 严旺 陈才敬 《中风与神经疾病杂志》 CAS 2024年第1期63-67,共5页
目的探讨阿尔茨海默病患者神经丝轻链蛋白(neurofilament light chain,NfL)与临床特点相关性。方法分析2020年6月—2022年12月宁波市第二医院收治的58例阿尔茨海默病患者的临床资料为研究对象。检测58例阿尔茨海默病患者的神经丝轻链蛋... 目的探讨阿尔茨海默病患者神经丝轻链蛋白(neurofilament light chain,NfL)与临床特点相关性。方法分析2020年6月—2022年12月宁波市第二医院收治的58例阿尔茨海默病患者的临床资料为研究对象。检测58例阿尔茨海默病患者的神经丝轻链蛋白水平。Simoa法检测阿尔茨海默病患者神经丝轻链蛋白水平,探索神经丝轻链蛋白表达与临床因素的关联性。结果58例患者中女性患者33例,NfL水平为(24.93±17.07)pg/ml;男性患者24例,NfL水平为(28.14±17.98)pg/ml,差异无统计学意义。不同文化程度与NfL水平分别为:文盲[(27.87±14.75)pg/ml(7/58)]、小学[(15.22±9.62)pg/ml(7/58)]、初中[(27.95±15.60)pg/ml(14/58)]、高中[(12.84±2.97)pg/ml(4/58)]、中专[(37.35±26.63)pg/ml(7/58)]、大专[(33.79±21.81)pg/ml(5/58)]、大学[(15.22±9.62)pg/ml(7/58)],结果无统计学差异。用相关分析研究NfL和年龄、病程、海马分级,日常生活活动能力评定量表(Activities of Daily Living,ADL)分值,简易精神状态检查表(Mini-Mental State Examination,MMSE)分值,长谷川痴呆量表(Hasegawa Dementia Scale,HDS)分值之间的相关关系,Pearson相关系数(r)表示相关关系的强弱情况。NfL和年龄的r值为0.448,提示NfL和年龄呈正相关。NfL和病程之间的r值为0.045,且P>0.05,说明NfL和病程无相关关系。NfL和海马分级的r值为0.345,说明NfL和海马分级有正相关关系。NfL和ADL分值之间的r值为0.242,P>0.05,说明NfL和ADL分值无相关关系。NfL和MMSE分值的相r值为‒0.099,P>0.05,说明NfL和MMSE分值无相关关系。NfL和HDS分值的r值为‒0.096,P值为0.475>0.05,说明NfL和HDS分值之间没有相关关系。结论阿尔茨海默病患者血清神经丝轻链蛋白水平与患者年龄,磁共振海马分级呈正相关,与性别、文化程度、病程、ADL分值、MMSE分值、HDS分值无相关关系。 展开更多
关键词 阿尔茨海默病 神经丝轻链蛋白 临床因素 相关性
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β_(2)-肾上腺素能受体与神经丝在山羊脾中的分布和共定位研究
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作者 李晓萌 窦体馨 +4 位作者 李志伟 叶守冲 杨松桦 徐永平 武永杰 《动物医学进展》 北大核心 2024年第2期48-53,共6页
为探讨肾上腺素能神经与脾功能联系,用免疫组织化学SP法和免疫荧光双标记法观察β_(2)-肾上腺素能受体(β_(2)-AR)和羊脾神经丝(NFs)在山羊脾中的表达分布特点。结果显示,β_(2)-AR免疫反应阳性产物在山羊脾中分布广泛,白髓、红髓、中... 为探讨肾上腺素能神经与脾功能联系,用免疫组织化学SP法和免疫荧光双标记法观察β_(2)-肾上腺素能受体(β_(2)-AR)和羊脾神经丝(NFs)在山羊脾中的表达分布特点。结果显示,β_(2)-AR免疫反应阳性产物在山羊脾中分布广泛,白髓、红髓、中央动脉、被膜、小梁、边缘区均有不同程度的着色,白髓中免疫组化染色阳性相对表达量极显著高于红髓(P<0.01),极极显著高于边缘区和被膜(P<0.001);红髓中免疫组化染色阳性相对表达量极显著高于边缘区和被膜(P<0.01);NFs免疫反应阳性产物在山羊脾中红髓、被膜、小梁、小血管、白髓和边缘区均有不同程度的着色,红髓中免疫组化染色阳性相对表达量显著高于白髓(P<0.05),极显著高于边缘区(P<0.01);被膜中免疫组化染色阳性相对表达量极显著高于边缘区和白髓(P<0.01)。共定位研究表明β_(2)-AR和NFs在3个区域存在共定位关系,在平滑肌细胞构成的被膜和小梁中存在,在富含平滑肌细胞的小血管(如中央动脉)中存在,在T、B淋巴细胞丰富区域(如白髓、红髓和边缘区)存在。表明交感-肾上腺素能神经系统对机体免疫具有调控作用。β_(2)-AR和NFs共定位结构证明脾受到交感-肾上腺素能神经的调控,交感神经纤维通过释放神经递质-去甲肾上腺素,作用于脾上的肾上腺素能受体实现功能调控。 展开更多
关键词 β_(2)-肾上腺素能受体 神经丝蛋白 山羊
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奥拉西坦腹腔注射后缺氧缺血性脑损伤新生大鼠海马组织形态变化及NFP、CRMP-2表达观察 被引量:7
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作者 张洋 王显鹤 吴祥红 《山东医药》 CAS 2019年第9期28-31,共4页
目的观察奥拉西坦腹腔注射后缺氧缺血性脑损伤(HIBD)新生大鼠海马组织形态变化及神经丝蛋白(NFP)和坍塌反应介导蛋白-2(CRMP-2)表达变化,以探讨其对神经元的保护作用机制。方法将120只清洁级7日龄Wistar大鼠随机分为对照组、模型组和治... 目的观察奥拉西坦腹腔注射后缺氧缺血性脑损伤(HIBD)新生大鼠海马组织形态变化及神经丝蛋白(NFP)和坍塌反应介导蛋白-2(CRMP-2)表达变化,以探讨其对神经元的保护作用机制。方法将120只清洁级7日龄Wistar大鼠随机分为对照组、模型组和治疗组。对照组仅手术分离左侧颈总动脉,未进行永久性结扎,未进行缺氧处理;模型组缺血缺氧制作HIBD模型,缺氧后10 min腹腔注射生理盐水0.1 ml/kg;治疗组在HIBD模型制备成功后6 h、12 h、24 h、72 h、7 d腹腔注射100 mg/kg奥拉西坦注射液,并于上述不同时间点处死各组大鼠进行病理学观察,免疫组化法检测各组大鼠海马NFP和CRMP-2。结果 HE染色显示对照组细胞形态结构完整,层次清晰,无细胞水肿;模型组细胞肿胀,排列紊乱,细胞质疏松,核仁不清;治疗组大多数神经元肿胀,与模型组相比,水肿减轻,结构清晰,可见尼氏小体,无坏死灶。模型组海马组织CRMP-2阳性细胞在模型建立成功后12 h表达开始升高,24 h达到高峰,随后表达逐渐降低;而NFP阳性细胞在模型建立成功后6 h表达,12 h开始下降,24 h下降至最低,之后逐渐升高。与模型组比较,在模型建立后6 h外其他时点,治疗组海马组织CRMP-2表达均低于模型组(P<0.05);上述各时点治疗组NFP表达均高于模型组(P均<0.05)。结论奥拉西坦腹腔注射后HIBD新生大鼠海马组织结构改善,奥拉西坦可通过降低海马组织CRMP-2表达,增加NFP表达,从而对HIBD新生大鼠神经元起保护作用。 展开更多
关键词 奥拉西坦 缺氧缺血性脑损伤 坍塌反应介导蛋白-2 神经丝蛋白
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外胚层间充质干细胞来源细胞外囊泡促进神经元轴突的伸长
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作者 孙海涛 任春朋 +3 位作者 杨永涛 黄永辉 秦入结 李震 《中国组织工程研究》 CAS 北大核心 2025年第23期4924-4930,共7页
背景:神经元轴突损伤可致神经功能障碍,促进轴突伸长有望在神经系统疾病治疗中发挥重要作用。目的:探究外胚层间充质干细胞来源细胞外囊泡(ectomesenchymal stem cells-derived extracellular vesicles,EMSC-EVs)能否促进神经元轴突伸... 背景:神经元轴突损伤可致神经功能障碍,促进轴突伸长有望在神经系统疾病治疗中发挥重要作用。目的:探究外胚层间充质干细胞来源细胞外囊泡(ectomesenchymal stem cells-derived extracellular vesicles,EMSC-EVs)能否促进神经元轴突伸长。方法:(1)组织贴壁法获取鼻黏膜来源外胚层间充质干细胞,免疫荧光鉴定特异性标志物;超速离心法获取EMSC-EVs并进行鉴定;(2)EMSC-EVs(0,0.5,1.0,1.5 mg/mL)与PC12细胞共孵育72 h,CCK-8分析EMSC-EVs对PC12细胞的细胞毒性及增殖作用;(3)EMSC-EVs(1.0 mg/mL)与PC12细胞或神经元共孵育72 h,显微镜下观察轴突长度变化,实时荧光定量PCR及Western blot分析轴突相关标志物微管蛋白β3(早期)、生长相关蛋白43(中期)和神经丝蛋白200(成熟)表达变化,以探究EMSC-EVs是否能够促进PC12细胞或神经元轴突伸长。结果与结论:(1)所获取外胚层间充质干细胞大部分呈长梭形,少数呈不规则形,高表达间充质干细胞特异性标记物Nestin、CD44及Vimentin;所获取EMSC-EVs符合细胞外囊泡的生物学标准;(2)在0.5-1.5 mg/mL质量浓度范围内,EMSC-EVs促进PC12细胞增殖,且随浓度增加而增强;(3)EMSC-EVs促进PC12细胞及神经元轴突长度增加,促进轴突相关标志物微管蛋白β3、生长相关蛋白43和神经丝蛋白200的表达。这些结果说明,EMSC-EVs能够促进神经元轴突伸长。 展开更多
关键词 间充质干细胞 神经元 PC12细胞 细胞外囊泡 轴突伸长 微管蛋白β3 生长相关蛋白43 神经丝蛋白200
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血浆GFAP与NfL水平评估创伤性脑损伤患者疾病严重程度及预后的价值
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作者 何晓峰 邓文静 《中国实用神经疾病杂志》 2024年第7期826-830,共5页
目的探讨血浆GFAP、NfL水平评估创伤性脑损伤(TBI)患者疾病严重程度及预后的价值。方法纳入40例TBI患者(创伤组),16例健康对照者(对照组),应用Simoa HD-X平台检测血浆GFAP、NfL水平,格拉斯哥预后扩展量表(GOSE)评估患者预后,使用lnGFAP... 目的探讨血浆GFAP、NfL水平评估创伤性脑损伤(TBI)患者疾病严重程度及预后的价值。方法纳入40例TBI患者(创伤组),16例健康对照者(对照组),应用Simoa HD-X平台检测血浆GFAP、NfL水平,格拉斯哥预后扩展量表(GOSE)评估患者预后,使用lnGFAP、lnNfL和平均指标(lnGFAP与lnNfL均值)进行分析。结果创伤组血浆lnGFAP及lnNfL值较对照组显著升高,差异有统计学意义(P<0.001)。血浆lnGFAP及lnNfL值在重度TBI患者中显著增高(P<0.001),在轻度与中度TBI患者中无统计学差异(P>0.05)。lnGFAP、lnNfL和平均指标与GCS评分(rs=-0.723、-0.791、-0.838)、GOSE评分(rs=-0.671、-0.704、-0.771)呈负相关,对伤后6个月不良预后(AUC=0.83、0.83、0.89)和病死率(AUC=0.91、0.91、0.94)有预测价值。结论TBI患者急性期血浆GFAP、NfL水平有助于疾病早期病情判断和预后评估,平均指标的效果优于单个指标。 展开更多
关键词 创伤性脑损伤 生物标记物 纤维酸性蛋白 神经丝蛋白 病情判断 预后评估
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脑小血管病患者血清NFL、GFAP水平与睡眠障碍的关系
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作者 黎昌炫 朱娴 +2 位作者 陈奕斌 陈浩 李威 《脑与神经疾病杂志》 CAS 2024年第7期405-408,共4页
目的探讨脑小血管病(CSVD)患者血清神经丝轻链(NFL)、胶质纤维酸性蛋白(GFAP)水平与睡眠障碍的关系。方法选取2020年1月至2022年12月海南医学院第一附属医院神经内科收治的153例CSVD患者,根据匹茨堡睡眠质量指数(PSQI)量表评分分为睡眠... 目的探讨脑小血管病(CSVD)患者血清神经丝轻链(NFL)、胶质纤维酸性蛋白(GFAP)水平与睡眠障碍的关系。方法选取2020年1月至2022年12月海南医学院第一附属医院神经内科收治的153例CSVD患者,根据匹茨堡睡眠质量指数(PSQI)量表评分分为睡眠障碍组(PSQI≥10分)和睡眠正常组(PSQI<10分)。对比两组一般临床资料及血清NFL、GFAP水平,分析血清NFL、GFAP水平与CSVD患者睡眠障碍的关系。结果153例CSVD患者中发生睡眠障碍56例,发病率36.60%。睡眠障碍组患者年龄、脑白质高信号(WMH)比例明显高于睡眠正常组(P<0.05),睡眠障碍组血清NFL、GFAP水平也高于睡眠正常组(P<0.05)。CSVD患者血清NFL、GFAP水平与PSQI评分呈显著正相关(P<0.05)。Logistic分析显示,年龄大、脑白质病变、血清NFL和GFAP升高是CSVD患者发生睡眠障碍的危险因素(P<0.05)。结论血清NFL、GFAP水平与CSVD患者睡眠障碍密切相关,其水平升高是睡眠障碍的重要危险因素。 展开更多
关键词 脑小血管病 睡眠障碍 神经丝轻链 胶质纤维酸性蛋白
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Blood diagnostic and prognostic biomarkers in amyotrophic lateral sclerosis
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作者 Yongting Lv Hongfu Li 《Neural Regeneration Research》 SCIE CAS 2025年第9期2556-2570,共15页
Amyotrophic lateral sclerosis is a devastating neurodegenerative disease for which the current treatment approaches remain severely limited.The principal pathological alterations of the disease include the selective d... Amyotrophic lateral sclerosis is a devastating neurodegenerative disease for which the current treatment approaches remain severely limited.The principal pathological alterations of the disease include the selective degeneration of motor neurons in the brain,brainstem,and spinal cord,as well as abnormal protein deposition in the cytoplasm of neurons and glial cells.The biological markers under extensive scrutiny are predominantly located in the cerebrospinal fluid,blood,and even urine.Among these biomarke rs,neurofilament proteins and glial fibrillary acidic protein most accurately reflect the pathologic changes in the central nervous system,while creatinine and creatine kinase mainly indicate pathological alterations in the peripheral nerves and muscles.Neurofilament light chain levels serve as an indicator of neuronal axonal injury that remain stable throughout disease progression and are a promising diagnostic and prognostic biomarker with high specificity and sensitivity.However,there are challenges in using neurofilament light chain to diffe rentiate amyotrophic lateral sclerosis from other central nervous system diseases with axonal injury.Glial fibrillary acidic protein predominantly reflects the degree of neuronal demyelination and is linked to non-motor symptoms of amyotrophic lateral sclerosis such as cognitive impairment,oxygen saturation,and the glomerular filtration rate.TAR DNA-binding protein 43,a pathological protein associated with amyotrophic lateral sclerosis,is emerging as a promising biomarker,particularly with advancements in exosome-related research.Evidence is currently lacking for the value of creatinine and creatine kinase as diagnostic markers;however,they show potential in predicting disease prognosis.Despite the vigorous progress made in the identification of amyotrophic lateral sclerosis biomarkers in recent years,the quest for definitive diagnostic and prognostic biomarke rs remains a formidable challenge.This review summarizes the latest research achievements concerning blood biomarkers in amyotrophic lateral sclerosis that can provide a more direct basis for the differential diagnosis and prognostic assessment of the disease beyond a reliance on clinical manifestations and electromyography findings. 展开更多
关键词 amyotrophic lateral sclerosis BIOMARKER blood biomarkers diagnosis glial fibrillary acidic protein neurofilament light chain PROGNOSIS TAR DNA-binding protein 43
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神经退行性疾病患者血清神经丝轻链蛋白水平变化的Meta分析
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作者 付旭东 李茂庚 +2 位作者 程波 冯宇梁 张树山 《医学新知》 CAS 2024年第4期424-437,共14页
目的系统评价血清神经丝轻链蛋白(neurofilament light chain protein,NfL)在神经退行性疾病及不同认知损害程度患者中的变化。方法计算机检索PubMed、Embase、Web of Science、中国知网、万方和中国生物医学文献库数据库,纳入阿尔茨海... 目的系统评价血清神经丝轻链蛋白(neurofilament light chain protein,NfL)在神经退行性疾病及不同认知损害程度患者中的变化。方法计算机检索PubMed、Embase、Web of Science、中国知网、万方和中国生物医学文献库数据库,纳入阿尔茨海默病(Alzheimer's disease,AD)、帕金森病(Parkinson's disease,PD)、多系统萎缩(multiple system atrophy,MSA)、进行性核上性麻痹(progressive supranuclear palsy,PSP)患者和健康对照均有血清NfL值的队列或病例对照研究,检索时间为建库至2023年4月30日。使用纽卡斯尔-渥太华量表评价纳入研究的风险偏倚,采用RevMan 5.4软件统计分析暴露组与非暴露组间的血清NfL值差异,合并效应量采用标准均数差(standard mean difference,SMD)及95%可信区间(confidence interval,CI)表示。结果纳入43篇文献,共提取了62项对比研究。对PD、AD、MSA、PSP与各自健康对照组分组比较,四组分别纳入9项、24项、9项、8项研究。PD组[SMD=0.27,95%CI(0.17,0.36)]、AD组[SMD=0.97,95%CI(0.70,1.23)]、MSA组[SMD=1.51,95%CI(0.97,2.05)]、PSP组[SMD=1.54,95%CI(1.14,1.93)]血清NfL水平均高于各自健康对照组。对帕金森病认知正常(PD normal cognitive,PD-NC)与帕金森病痴呆(PD with dementia,PD-D)、阿尔茨海默病轻度认知减退(AD mild cognitive impairment,AD-MCI)与阿尔茨海默病痴呆(AD with dementia,AD-D)分组比较,两对比组分别纳入3项和9项研究,PD-D患者血清NfL水平高于PD-NC患者[SMD=0.92,95%CI(0.63,1.20)],AD-D患者血清NfL水平高于AD-MCI患者[SMD=0.61,95%CI(0.49,0.72)]。结论PD、AD、MSA、PSP患者血清NfL水平较健康人群升高,且认知损害程度越大,血清NfL水平越高,血清NfL可能是神经退行性疾病潜在的外周生物标志物,能够进一步反映认知水平的下降。 展开更多
关键词 生物标志物 神经丝轻链蛋白 神经退行性疾病 阿尔茨海默病 帕金森病 进行性核上性麻痹 多系统萎缩 系统评价 META分析
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Storage time affects the level and diagnostic efficacy of plasma biomarkers for neurodegenerative diseases
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作者 Lifang Zhao Mingkai Zhang +4 位作者 Qimeng Li Xuemin Wang Jie Lu Ying Han Yanning Cai 《Neural Regeneration Research》 SCIE CAS 2025年第8期2373-2381,共9页
Several promising plasma biomarker proteins,such as amyloid-β(Aβ),tau,neurofilament light chain,and glial fibrillary acidic protein,are widely used for the diagnosis of neurodegenerative diseases.However,little is k... Several promising plasma biomarker proteins,such as amyloid-β(Aβ),tau,neurofilament light chain,and glial fibrillary acidic protein,are widely used for the diagnosis of neurodegenerative diseases.However,little is known about the long-term stability of these biomarker proteins in plasma samples stored at-80°C.We aimed to explore how storage time would affect the diagnostic accuracy of these biomarkers using a large cohort.Plasma samples from 229 cognitively unimpaired individuals,encompassing healthy controls and those experiencing subjective cognitive decline,as well as 99 patients with cognitive impairment,comprising those with mild cognitive impairment and dementia,were acquired from the Sino Longitudinal Study on Cognitive Decline project.These samples were stored at-80°C for up to 6 years before being used in this study.Our results showed that plasma levels of Aβ42,Aβ40,neurofilament light chain,and glial fibrillary acidic protein were not significantly correlated with sample storage time.However,the level of total tau showed a negative correlation with sample storage time.Notably,in individuals without cognitive impairment,plasma levels of total protein and tau phosphorylated protein threonine 181(p-tau181)also showed a negative correlation with sample storage time.This was not observed in individuals with cognitive impairment.Consequently,we speculate that the diagnostic accuracy of plasma p-tau181 and the p-tau181 to total tau ratio may be influenced by sample storage time.Therefore,caution is advised when using these plasma biomarkers for the identification of neurodegenerative diseases,such as Alzheimer's disease.Furthermore,in cohort studies,it is important to consider the impact of storage time on the overall results. 展开更多
关键词 Alzheimer’s disease amyloid-β diagnostic ability glial fibrillary acidic protein NEURODEGENERATION neurofilament light chain plasma biomarkers single molecule array storage time tau
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脑脊液NF-L pNF-H与脊髓性肌萎缩症患者病情严重程度及治疗的相关性
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作者 徐丹丹 王磊 +7 位作者 臧欢欢 诸宏伟 刁艳霞 关艳春 岳倩文 夏群 张微笑 周瑞 《中国实用神经疾病杂志》 2024年第8期975-980,共6页
目的探讨脑脊液神经丝蛋白轻链(NF-L)及磷酸化神经丝蛋白重链(pNF-H)水平与脊髓性肌萎缩症(SMA)患者病情及治疗的相关性。方法选取2022-02—2023-08蚌埠医科大学第一附属医院儿科确诊为脊髓性肌萎缩(SMA)并接受诺西那生钠治疗的22例患... 目的探讨脑脊液神经丝蛋白轻链(NF-L)及磷酸化神经丝蛋白重链(pNF-H)水平与脊髓性肌萎缩症(SMA)患者病情及治疗的相关性。方法选取2022-02—2023-08蚌埠医科大学第一附属医院儿科确诊为脊髓性肌萎缩(SMA)并接受诺西那生钠治疗的22例患儿为研究对象,收集患儿性别、基因检测结果、疾病分型、开始治疗的年龄、发病年龄、开始治疗前疾病持续时间等基本信息,于诺西那生钠鞘内注射前收集脑脊液标本并检测脑脊液NF-L、pNF-H水平,采用汉默史密斯功能性运动量表扩展版(HFMSE)及上肢模块修订版(RULM)对SMA患儿进行运动功能评估,比较SMA患儿开始治疗时脑脊液NF-L、pNF-H水平,分析脑脊液NF-L、pNF-H水平与开始治疗的年龄、治疗前疾病持续时间及运动功能的相关性,对比治疗期间脑脊液NF-L、pNF-H水平。结果Ⅱ型与Ⅲ型SMA患儿脑脊液NF-L水平(438.15±163.41比283.47±108.11)存在统计学差异(t=2.123,P=0.047),与Ⅱ型、Ⅲ型SMA患儿HFMSE评分(r=-0.521,P=0.15)及RULM评分(r=-0.528,P=0.014)呈负相关,接受诺西那生钠治疗后差异有统计学意义(381.21±166.80比284.94±150.08比194.53±91.09)(Z=23.684,P<0.001);Ⅱ型与Ⅲ型SMA患儿脑脊液pNF-H水平(335.04±110.30比251.64±146.64)差异无统计学意义(P>0.05),与Ⅱ型、Ⅲ型SMA患儿HFMSE评分(r=-0.471,P=0.31)及RULM评分(r=-0.577,P=0.006)呈负相关,接受诺西那生钠治疗后差异有统计学意义(306.71±128.85比179.64±69.28比130.85±49.60)(Z=22.842,P<0.001)。结论脑脊液NF-L、pNF-H水平与SMA患儿病情严重程度呈负相关,并在接受诺西那生钠修正治疗后降低。 展开更多
关键词 脊髓性肌萎缩 神经丝蛋白轻链 磷酸化神经丝蛋白重链 诺西那生钠
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