视神经脊髓炎脑脊液生化指标及颅脑磁共振影像学的关系  

A relationship between the brain magnetic resonance imaging of optic nerve myelitis patients and their CSF biochemical indexes

作　　者：于晓雯[1] 王晓晴[2] 张文俊[1] 拓西平[1] 

机构地区：[1] 第二军医大学附属长海医院老年病科,上海市200433 [2] 第二军医大学附属长海医院神经内科,上海市200433

出　　处：《中国基层医药》2015年第16期2431-2433,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：比较视神经脊髓炎（NMO）患者伴颅脑磁共振（MRI）异常信号者与 MRI 表现无明显异常者脑脊液生化指标的差异。方法收集满足 Wingerchuck 诊断标准的患者39例，回顾性分析脑部 MRI 及脑脊液、血液相关生化指标值。结果两组患者在起病年龄、平均年龄、住院天数、红细胞数、白细胞数、血红蛋白、脑脊液（CSF）白细胞数、CSF 总细胞数、IgG 合成指数、脑脊液 IgG、鞘内合成率等指标上差异无统计学意义，而血脑屏障指数（CSF：serum albumin ratio，AR）则 NMO 颅脑 MRI 异常组高于正常组（P ＜0．05）。结论NMO 患者出现脑内异常比较常见，且颅脑 MRI 显示异常者血脑屏障破坏的标志 AR 值较高，推测 NMO 患者脑部 MRI 异常信号灶与血脑屏障破坏相关，探讨 NMO 颅脑 MRI 表现对完善 NMO 的诊断标准及同多发性硬化（multiple sclerosis，MS）鉴别具有一定的帮助。Objective To compare differences of CSF biochemical index in optic myelitis combined with abnormal signal in craniocerebral MRI with no significant abnormalities in brain MRI.Methods The data of 39 cases who meet the diagnostic criteria of Wingerchuck were collected.The brain MRI and cerebrospinal fluid,blood bio-chemical indexes were retrospectively analyzed.Results There were no statistical differences between two groups of patients in onset age,average age,hospitalization days,the number of red blood cells,white blood cell,hemoglobin, cerebrospinal fluid leukocyte and CSF synthetic index,the total number of cells,cerebrospinal fluid IgG,synthetic rate index of sheath,but the index of blood brain barrier（CSF：serum albumin ratio,AR）of NMO patients with craniocere-bral MRI abnormalities was higher than normal group（P 〈0.05）.Conclusion NMO patients with brain abnormali-ties are common,and cerebral MRI with signs of abnormalities shows a higher AR value,speculated that abnormal brain MRI signal in NMO patients is associated with the damage of blood -brain barrier,investigation of NMO brain MRI performance can improve the diagnosis of the NMO and identification with multiple sclerosis.

关 键 词：视神经脊髓炎 磁共振成像 脑脊液 

分 类 号：R744.52[医药卫生—神经病学与精神病学]