中枢神经系统脱髓鞘疾病和其他类型中枢神经系统疾病差异指标的筛选  

Screening for differentiate indicators between CNS demyelinating diseases and other types of CNS diseases

作　　者：姜文灿 殷晓暄 李晓彤 单凯[2] JIANG Wen-can;YIN Xio-ruan;LI Xiao-tong;无(Department of Clinical Laboratory,Beijing Tiantan Hospital,Cap-ital medical University,Beijing 100070,China;Department of Emergency,Beijing Tiantan Hospital,Capital medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院实验诊断中心,北京100070 [2]首都医科大学附属北京天坛医院急诊科,北京100070

出　　处：《中国实验诊断学》2023年第5期505-511,共7页Chinese Journal of Laboratory Diagnosis

基　　金：北京市医管中心“扬帆计划”(ZYLX202108);国家自然科学基金青年项目(82202623);北京市科学技术协会青年人才托举工程(BYESS2022170)。

摘　　要：目的寻找中枢神经系统脱髓鞘疾病和其他中枢神经系统疾病的差异指标,以期辅助诊断。方法收集首都医科大学附属北京天坛医院2019年至2021年确诊为视神经脊髓炎谱系疾病、多发性硬化、格林巴利综合征和中枢神经系统炎性脱髓鞘疾病的患者作为脱髓鞘组,确诊为自身免疫性脑炎、阿尔茨海默病和病毒性脑炎的患者作为非脱髓鞘组,根据临床检验指标的特点和临床伴随疾病情况开展对比分析。结果共收集脱髓鞘组204例、非脱髓鞘组46例;脱髓鞘疾病以女性为主(72/132),非脱髓鞘疾病男女发病比例(25/21)基本均等;两组间年龄(P=0.011)、性别(P=0.019)存在显著性差异;对于常规检验结果分析,HCY(P=0.003)、CK(P=0.090)、补体C4(P=0.002)、FT4(P=0.030)、抗nRNP抗体(P=0.030)、组蛋白抗体(P=0.006)、脑脊液寡克隆电泳[CSF(OB)]阳性率(P=0.019)存在显著性差异;对于伴发疾病分析,脱髓鞘疾病组心血管疾病(P=0.038)、脑血管疾病(P=0.001)发生率显著性高于非脱髓鞘疾病组,感染(P=0.001)呈相反趋势。结论年龄、性别、心脑血管疾病发生情况、感染情况、HCY、CK、补体C4、FT4、CSF(OB)可以用于中枢神经系统脱髓鞘疾病和非脱髓鞘疾病的辅助诊断。Objective To find the differential indicators of central nervous system(CNS)demyelinating diseases and other CNS diseases with the aim of assisting diagnosis.Methods Patients diagnosed with neuromyelitis optica spectrum disorders(NMOSD),multiple sclerosis(MS),Guillain-Barre syndrome(GBS)and inflammatory demyelinating diseases(IDDs)of the CNS from 2019 to 2021 at Beijing Tiantan Hospital,Capital Medical University,were collected as the demyelinating group.And patients diagnosed with autoimmune encephalitis(AE),Alzheimers disease(AD)and viral encephalitis(VE)were collected as the non-demyelinating group.Comparative analysis was carried out according to the clinical characteristics and laboratory indicators.Results A total of 204 cases in the demyelinating group and 46 cases in the non-demyelinating group were collected.The demyelinating disease was predominantly female,with the male to female ratio(72/132).The non-demyelinating disease had an almost equal male to female incidence ratio(25/21).There were significant differences in age(P=0.011)and gender(P=0.019)between the two groups.The incidence of cardiovascular disease(P=0.038)and cerebrovascular disease(P=0.001)was significantly higher in the demyelinating disease group,with an opposite trend for infection(P=0.0015).Besides,HCY(P=0.003),CK(P=0.090),complement C4(P=0.002),FT4(P=0.030),anti-nRNP antibody(P=0.030),histone antibody(P=0.006),and the positive rate of cerebrospinal fluid oligoclonal electrophoresis[CSF(OB)](P=0.019)were significantly different between the two groups.Conclusion Age,gender,occurrence of cardiovascular and cerebrovascular diseases,infections,HCY,CK,C4,FT4,CSF(OB)can be used in the diagnosis of demyelinating and non-demyelinating diseases of the CNS.

关 键 词：中枢神经系统脱髓鞘疾病 检验指标 伴随疾病 差异指标 

分 类 号：R446.5[医药卫生—诊断学]