多发性硬化患者血清褪黑激素和TNF-α水平与EDSS评分的相关性  

Correlation between Serum Levels of Melatonin TNF-A and EDSS Scores in Multiple Sclerosis Patients

作　　者：艾宝 刘国懿 马舒 刘诗翔 孔繁一[2] 艾青龙[3] 耿嘉[3] AI Bao LIU Guo-yi MA Shu LIU Shi-xiang KONG Fan-yi AI Qing-long GENG Jia(） The Lancang County People＇s Hospital of Pu＇er City, Puer Yunnan 665600 ） Dept. of Neurology, The People＇s Liberation Army General Hospital In Kunmin ） Dept. of Neurology, The 1st Affiliated Hospital of Kunming Medical University, Kunming Yunnan 650032, China)

机构地区：[1]澜沧县人民医院内三科,云南普洱665600 [2]解放军昆明总医院神经内科 [3]昆明医科大学第一附属医院神经内科,云南昆明650032

出　　处：《昆明医科大学学报》2016年第9期100-103,共4页Journal of Kunming Medical University

基　　金：云南省应用基础研究基金资助项目(2013FB146)

摘　　要：目的探讨多发性硬化(MS)患者血清褪黑激素、肿瘤坏死因子-α(TNF-α)和γ-干扰素(IFN-γ)水平变化与致残状况的相关性.方法收集40例MS患者和30例健康体检者分别作为实验组及对照组,应用酶联免疫吸附法(ELISA)检测实验组与对照组间血清褪黑激素、TNF-α、IFN-γ水平;应用EDSS量表评价所有MS患者致残状况;并进一步对MS患者血清褪黑激素、TNF-α、IFN-γ水平及EDSS评分进行相关性分析.结果 MS组血清褪黑激素浓度明显低于正常人群(P<0.01),TNF-α水平明显高于正常对照人群(P<0.05),2组间比较差异有统计学意义;MS组和对照组之间血清IFN-γ无显著差异.MS患者血清褪黑激素水平与EDSS评分呈显著负相关(r=-0.76,P<0.01),而TNF-α则呈正相关(r=0.83,P<0.01),而与IFN-γ无显著相关性(r=0.17,P>0.05).结论血清褪黑激素的下调及TNF-α的上调可以影响MS患者的炎症反应过程,并与MS患者功能残障程度密切相关;血清褪黑激素及TNF-α可以作为监测MS临床疗效及评估预后的实验室指标.Objective To study the serum levels of melatonin, tumor necrosis factor alpha（TNF-α） and interferon gamma（IFN-γ） in multiple sclerosis（MS） patients and the correlation with disability. Methods Forty patients with multiple sclerosis were collected as MS group and 30 healthy participants were collected as control group. Serum levels of melatonin and cytokines, including IFN-γ and TNF-, were detected in all participants by the enzyme-linked immunosorbent assay（ELISA） method; disability status of patients with MS was evaluated by EDSS scale. The relevant analysis between serum melatonin, TNF-α, IFN-γ levels and EDSS score in patients with MS was conducted. Results The concentration of serum melatonin in MS group was significantly lower than control group（P〈0.01）. TNF-α levels were higher than control group（P〈0.05） and the difference was statistically significant between MS patients and control group. Among MS group and control group, no significant correlation with the serum levels of IFN-γ was seen. The serum melatonin level was inversely correlated with EDSS score in MS patients（r =-0.76,P〉0.01）,and positively correlated with TNF-α（r = 0.83,P〉0.01） and as compared to IFN-γ,no significant correlation was found（r = 0.17,P〈0.05）. Conclusion The decrease ofmelatonin and increase of TNF-α can be a factor in the inflammatory reaction in patients with MS,and is closely related with dysfunction occurring in multiple sclerosis. Serum melatonin and TNF-αcan be used as laboratory indicators to monitor clinical curative effect and evaluate prognosis of MS.

关 键 词：多发性硬化 褪黑激素 TNF-Α IFN-Γ 临床扩展致残量表评分 

分 类 号：R593.2[医药卫生—内科学]