脑脊液CXCL12、PDGF及CXCL14水平和变化与视神经炎和视神经脊髓炎的关系  

Relationship between the levels and variation of CXCL12, PDGF, CXCL14 in cerebrospinal fluid of optic neuritis and neuromyelitis optica

作　　者：姜兆财[1] 魏世辉[1] 刘子豪[1] 李红阳[1] 陈霆隽[1] 

机构地区：[1]解放军总医院眼科,北京100853

出　　处：《中华眼科杂志》2015年第12期901-906,共6页Chinese Journal of Ophthalmology

基　　金：国家高技术研究发展计划（2015AA020511）

摘　　要：目的探讨视神经炎和视神经脊髓炎（NMO）患者脑脊液中趋化因子12（CXCL12）、血小板源性生长因子（PDGF）及趋化因子14（CXCL14）的水平和变化在视神经炎和NMO的预后和转归方面的预测价值。方法回顾性系列病例研究。收集2012年9月至2013年9月就诊于解放军总医院神经眼科的视神经炎患者35例，NMO患者10例及颅内静脉窦血栓形成（CVST）患者10例的临床资料及脑脊液检测结果。用酶联免疫吸附剂测定（ELISA）法检测脑脊液中CXCL12、PDGF及CXCL14的浓度。采用单因素方差分析（ANOVA）比较不同疾病、不同视神经炎发病时期、视神经炎磁共振成像扫描（MRI）表现及视神经炎是否复发等情况下脑脊液中CXCL12、PDGF及CXCL14含量的差异，组间的两两比较采用LSD法。ON不同发病时期MRI阳性率的比较采用确切概率法检验。同时对CXCL12、PDGF及CXCL14含量与白细胞数、IgG含量及蛋白质含量等参数进行相关性分析。结果视神经炎组（4．39-±0．51、2．51±0．39、8．65±1．55）和CVST组（4．84-±0．49、2．79-±0．47、10．53-±l_11）脑脊液CXCL12、PDGF、CXCL14的水平均明显高于NMO组患者（3．69±0．35、2．04±0．24、7．05±0．94）（F=14．593、10．060、10．003，P值均〈0．01），其中CVST组患者脑脊液CXCL12、PDGF、CXCL14水平高于视神经炎组；视神经炎急性期组（4．63±0．50、2．65±0．40）和CVST组（4．84±0．49、2．79±0．47）脑脊液中CXCL12、PDGF水平比视神经炎平稳期组（4．13±0．39、2．34±0．32）高（F=8．823、4．906，P=0．001、0．012）；35例视神经炎患者中28例进行了颅脑或眼眶MRI检查，MRI检查阳性组（3．96±0．30、2．23±0．16）的患者脑脊液CXCL12及PDGF水平高于阴性组（4．64±0．42、2．62±0．42）的患者（t=-4．754、-2．977，P〈0．001、0．006）；此外，脑脊液中CXCL12与PDGF水平变化有相关性（P〈0．01）�Objective To explore the predictive value of the prognosis and outcome for optic neuritis （ON） and neuromyelitis optica （NMO） by investigating the levels and variation of CXCL12, PDGF and CXCLI4 in CSF of patients with ON and NMO.Methods Retrospective study. Thirty-five patients with ON, 10 patients with NMO and 10 patients with cerebral venous sinus thrombosis （CVST） were scheduled in the research unit from September 2012 to September 2013 in Neuro-Ophthalmology Department of PLA General Hospital. Clinical data and cerebrospinal fluid （CSF） parameters were collected. CXCL12, PDGF and CXCL14 concentrations were measured in CSF using enzyme linked immunosorbent assay （ELISA）. The CXCL12, PDGF and CXCL14 levels in CSF were compared by using ANOVA in different diseases with different phases and recurrent cases found by MRI. Multiple comparisons were used by LSD method. The comparison of positive rate for MRI in ON different phases was used by exact probability. Meanwhile,correlation analysis was conducted between CXCL12, PDGF, CXCL14 and white blood cells （WBC）, IgG and protein in CSF. Results Compared with NMO group （3.69±0.35, 2.04±0.24, 7.05±0.94）, the CXCL12, PDGF and CXCL14 levels in CSF were higher in ON （4.39±0.51, 2.51 ±0.39, 8.65± 1.55） and CVST （4.84± 0.49, 2.79±0.47, 10.53± 1.11 ） group （F=14.593, 10.060, 10.003, P〈0.001, 〈0.001, 〈0.001）, especially the CXCL12, PDGF and CXCL14 levels in CSF of CVST group patients were higher than that in ON group. Among them, the CXCL12 and PDGF levels in CSF were higher in acute phase of ON （4.63±0.50, 2.65± 0.40） and CVST（4.84±0.49, 2.79±0.47） group than stationary phase of ON（4.13±0.39, 2.34±0.32） group （F=8.823, 4.906, P=0.001, 0.012）. In addition, 28 of 35 ON patients were conducted the cerebral or orbital magnetic resonance imaging （MRI）. The result showed that the CXCL12 and PDGF levels in CSF of patients with positive finding in MRI（3.96±0.30, 2.23±0.16） were higher than those p

关 键 词：视神经炎 视神经脊髓炎 趋化因子CXCL12 血小板源性生长因子 趋化因子 CXC 

分 类 号：R774.61[医药卫生—眼科] R744.52[医药卫生—临床医学]