多发性硬化患者病情演变与血浆和脑脊液趋化因子CXCL10水平的相关性  

Correlation of CXCLIO levels in plasma and cerebrospinal fluid with clinical course in patients with multiple sclerosis evolution

作　　者：刘喷飓[2] 张星虎[1] 吕莹[3] 周衡 刘云[1] 刘伟[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经内科,100050 [2]首都医科大学附属北京安贞医院神经内科 [3]北京市垂杨柳医院神经内科

出　　处：《中华神经科杂志》2011年第7期448-450,共3页Chinese Journal of Neurology

摘　　要：目的观察急性期多发性硬化（MS）患者血浆和脑脊液中趋化因子CXCL10水平的动态变化规律及其与临床神经功能障碍的相关性，探讨其对疾病活动性的判定价值。方法收集急性期MS患者、缓解期MS患者及健康对照各53例，神经系统非炎性疾病（NIND）32例，采用酶联免疫吸附试验法检测血浆和脑脊液中CXCL10水平，并进行扩展残疾状况评分量表（EDSS）评分。结果（1）与急性期初期相比，急性期MS组患者第2、4周血浆CXCL10水平[（601±365）、（575±297）pg／ml]明显升高（t=-2．898、-2．651，P=0．001、0．003）；第4周脑脊液中CXCL10水平[（1807±803）pg／ml]与急性期初期比较差异无统计学意义。（2）急性期初期MS组血浆CXCL10水平明显高于缓解期MS组[（287±118）pg／ml，t=3．555，P=0．001]和健康对照组[（248±130）pg／ml，t=4．895，P=0．000]。（3）急性期MS组脑脊液CXCLl0水平[（1774±604）pg／ml]明显高于NIND组[（122±114）pg／ml，t=15．192，P=0．000]。（4）急性期MS组患者血浆与脑脊液中CXCL10水平间存在相关性（r=0．792，P=0．001）；脑脊液CXCL10水平与同期EDSS评分之间存在相关性（r=0．526，P=0．002）。结论（1）MS患者血浆中CXCL10水平对判断疾病活动性有一定的参考价值。（2）急性期MS患者血浆CXCL10水平能在一定程度上反映其在脑脊液中的水平。（3）检测急性期MS患者脑脊液CXCL10水平对判断临床功能障碍程度有一定的参考价值。Objective To investigate the evolution of CXCL10 in blood plasma and cerebrospinal fluid （CSF） during relapses of multiple sclerosis （ MS）, and the correlation between these and the clinical neurological dysfunction. Methods Fifty-three patients with definite MS during relapsing state （relapsing MS group） diagnosed by the McDonald criteria; fifty-three patients with definite MS during remitting state （remitting MS group） ; thirty-two patients with non-inflammatory neurologic disease （NIND group） and fifty-three healthy controls （ NC group） were enrolled in the study. Each patient clinical status was evaluated with the Expanded Disability Status Scale （EDSS）. Plasma and CSF levels were analyzed by enzyme-linked immunoassay. Results （1） The CXCL10 level in plasma in relapsing MS group elevated significantly between the2nd （（601±365） pg/ml, t= -2.898, P=0.001） and the4th （（575±297） pg/ml, t= -2. 651, P = 0. 003 ） week after relapsing; CXL10 in CSF （n = 32） did not changed significantly in the 4th week after relapsing（ （1807±803 ） pg/ml）. （2） The CXCL10 level in plasma in relapsing MS group were significantly higher than that in the healthy control group （ （248±130） pg/ml, t =4. 895, P =0. 000） and remitting MS group （（287± 118） pg/ml, t =3.555, P =0.001）. （3） The CXCL10 level in CSF in relapsing MS group （ （ 1774±604 ） pg/ml ） was significantly higher than that in NIND group （ （ 122±114） pg/ml, t = 15. 192, P = 0. 000）. （4） The CXCL10 level in plasma in relapsing MS group had correlation with that in CSF （r =0. 792, P = 0. 001 ）. The CXCL10 level in CSF in relapsing MS group had correlation with EDSS scores （ r = 0. 526, P = 0. 002）. Conclusions The CXCL10 level in plasma might be implemented as a paraclinical marker of disease activity in MS. The CXCL10 level in plasma of MS may be relevant to that in CSF. The CXCLIO level in CSF of MS may indicate the clinical neurological dysfunction.

关 键 词：多发性硬化 趋化因子CXCL10 血浆 脑脊髓液 

分 类 号：R744.51[医药卫生—神经病学与精神病学]