早晚期肌萎缩侧索硬化血肌酐与疾病严重程度的研究  

Creatinine and disease severity in early and late amyotrophic lateral sclerosis

作　　者：朱江[1] 赵斌[1] 黄永锋[1] 王迎 闫炳苍 张宏[1] 师仰宏[1] 封婷[1] Zhu Jiang;Zhao Bin;Huang Yongfeng;Wang Ying;Yan Bingcang;Zhang Hong;Shi Yanghong;Feng Ting(Department of Neurology,the First Hospital of YuLin,Shanxi 719000,China)

机构地区：[1]榆林市第一医院神经内科,陕西719000 [2]武警陕西榆林支队

出　　处：《脑与神经疾病杂志》2019年第6期362-366,共5页Journal of Brain and Nervous Diseases

基　　金：陕西省中医药管理局基金资助项目(LCMS020)

摘　　要：目的 探讨早晚期肌萎缩侧索硬化(ALS)患者血肌酐与疾病严重程度的关系。方法 对34例ALS患者进行了随访和评估,另选34例周围神经病作为对照组,对两组年龄、性别、胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白、血肌酐、乳酸脱氢酶、尿素、尿酸方面进行对比分析,ALS患者由两位神经内科副主任医师按修订版ALS功能量表(ALSFRS-R)评估,根据ALS的严重程度进行分级,其中I、II期为疾病早期组,Ⅳ、V为疾病晚期组,对早期组和晚期组患者年龄、性别、ALSFRS-R评分、血肌酐方面进行对比分析,并行ALSFRS-R评分与血肌酐相关性分析。结果 ①ALS组血肌酐(55.19±19.75)mmol·L^-1,周围神经病组血肌酐(64.80±12.05)mmol·L^-1,两组患者比较有统计学意义(P<0.05)。两组在胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白、乳酸脱氢酶、尿素、尿酸比较差异无统计学意义(P>0.05);②早期ALS组血肌酐(64.53±21.41)mmol·L^-1,晚期组血肌酐(49.12±16.33)mmol·L^-1,两组患者比较差异有统计学意义(P<0.05)。早期ALS组ALSFRS-R评分42.29±3.62,晚期组ALSFRS-R评分26.65±10.42,两组患者比较差异有统计学意义(P<0.05);③ALS患者血肌酐与患者ALSFRS-R评分做相关性分析显示呈正相关(r=0.081,P<0.05)。结论 血肌酐水平在ALS组较对照组明显降低,可反映ALS患者残余肌肉质量,血肌酐与ALS患者临床严重程度的相关性提示血肌酐可以较好地反映患者的严重程度,提示疾病进展,血肌酐有望成为监测疾病进展和评价药物疗效的一项生物学标记物。Objective To investigate the relationship between serum creatinine and severity in patients with early and late amyotrophic lateral sclerosis( ALS). Method 34 patients with ALS were followed up and evaluated. 34 cases of peripheral neuropathy were selected as the control group. The two groups were compared and analyzed in terms of age, sex, cholesterol, triglyceride, high density lipoprotein(HDL), low density lipoprotein(LDH), blood creatinine, lactate dehydrogenase, urea and uric acid. Patients with ALS were assessed by the revised ALS function scale (ALSFRS-R) by special neurology physicians. According to the severity of ALS, I and II were early disease group, IV and V were late disease group. The age, sex, ALSFRS-R score and serum creatinine were compared and analyzed in the early and late group, and the correlation of ALSFRS-R score and blood creatinine was analyzed. Results ① serum creatinine (55.19±19.75) mmol·L^-1 in group ALS, serum creatinine( 64.80±12.05) mmol·L-1 in peripheral neuropathy group, and there was a significant difference between two groups( P<0.05). There was no significant difference in cholesterol, triglyceride,( HDL), LDH, urea and uric acid between the two groups( P>0.05);② the serum creatinine in the early ALS group was( 64.53±21.41) mmol·L^-1, and the serum creatinine in the late group was( 49.12±16.33) mmol·L^-1, and there was a significant difference between the two group(s P<0.05). In the early ALS group, the ALSFRS-R score was 42.29±3.62, and the ALSFRS-R score in the late group was 26.65 ±10.42. There was a significant difference between the two groups( P<0.05);③ the correlation between serum creatinine and ALSFRS-R score of ALS patients showed a positive correlation( r=0.081, P<0.05). Conclusion the level of serum creatinine in group ALS is significantly lower than that of control group, which can reflect the residual muscle mass of patients with ALS. The correlation between serum creatinine and the clinical severity of ALS patients suggests that serum creatinine

关 键 词：早晚期肌萎缩侧索硬化 ALSFRS-R评分 血肌酐 疾病严重程度 

分 类 号：R744.8[医药卫生—神经病学与精神病学]