血清Hcy、UA、GAPDH与多发性硬化患者神经功能损害的关系及其预测效果  

Relationships of Serum Hcy,UA,GAPDH with Neurological Impairment in Patients with Multiple Sclerosis and Their Predictive Effect

作　　者：刘赵东 岳金利 LIU Zhaodong;YUE Jinli(department of neurology,donggang hospital of the first hospital of lanzhou university,lanzhou 730030,china;department of rehabilitation,donggang hospital of the first hospital of lanzhou university,lanzhou 730030,china)

机构地区：[1]兰州大学第一医院东岗院区神经内科,兰州730030 [2]兰州大学第一医院东岗院区康复科,兰州730030

出　　处：《医学综述》2023年第8期1661-1664,F0003,共5页Medical Recapitulate

摘　　要：目的探讨血清同型半胱氨酸(Hcy)、尿酸(UA)、3-磷酸甘油醛脱氢酶(GAPDH)与多发性硬化(MS)患者神经功能损害的关系及其预测效果。方法选取2019年10月至2021年7月兰州大学第一医院东岗院区收治的102例MS患者作为MS组,选取同期102例非MS患者作为非MS组。比较两组患者的血清Hcy、UA、GAPDH、神经元特异性烯醇化酶(NSE)、血清髓鞘碱性蛋白(MBP)水平和扩展残疾状态量表(EDSS)评分变化;采用Pearson分析MS组患者血清Hcy、UA、GAPDH水平与EDSS评分、NSE、MBP的关系;绘制Hcy、UA、GAPDH的受试者工作特征曲线(ROC曲线),分析其对MS患者神经功能情况的预测效果。结果MS组患者Hcy、GAPDH、NSE、MBP水平和EDSS评分均高于非MS组[(14±6)μmol/L比(9±3)μmol/L、0.81±0.17比0.72±0.25、(42.8±10.7)μg/L比(6.8±2.1)μg/L、(40.5±8.8)μg/L比(4.6±1.1)μg/L、(2.9±0.7)分比(1.7±0.6)分],而UA水平低于非MS组[(296±58)μmol/L比(343±95)μmol/L](P<0.01)。经Pearson分析显示,Hcy、GAPDH与EDSS评分、NSE、MBP均呈正相关(r=0.567、r=0.624、r=0.538、r=0.582、r=0.487、r=0.556,均P<0.01);UA与EDSS评分、NSE、MBP均呈负相关(r=-0.806、r=-0.713、r=-0.681,均P<0.01)。ROC曲线分析显示,Hcy预测MS神经功能损害的灵敏度为76.19%,特异度为80.25%,曲线下面积(AUC)为0.727(0.581~0.877);UA预测MS神经功能损害的灵敏度为66.67%,特异度为74.07%,AUC为0.661(0.517~0.783);GAPDH预测MS神经功能损害的灵敏度为85.71%,特异度为86.42%,AUC为0.837(0.713~0.935)。结论血清Hcy、UA、GAPDH水平均与MS患者神经功能损害密切相关,对MS早期神经功能损害具有一定的预测效能。Objective To investigate the relationships of serum homocysteine(Hcy),uric acid(UA),glyceraldehyde 3-phosphate dehydrogenase(GAPDH)with neurological impairment in patients with multiple sclerosis(MS)and their predictive effect.Methods A total of 102 patients with MS treated in Donggang Hospital of the First Hospital of Lanzhou University from Oct.2019 to Jul.2021 were included as an MS group,and 102 patients without MS in the same period were selected as a non-MS group.The changes of serum Hcy,UA,GAPDH,neuron-specific enolase(NSE),myelin basic protein(MBP)and expanded disability status scale(EDSS)were compared between the two groups.Pearson analysis was used to analyze the relationships of serum Hcy,UA,GAPDH levels with EDSS score,NSE,MBP in the MS group;the receiver operating characteristic(ROC)curves of Hcy,UA and GAPDH were drawn to analyze their predictive effect on the neurological function of MS patients.Results The levels of Hcy,GAPDH,NSE,MBP and EDSS score in the MS group were higher than those in the non-MS group[(14±6)μmol/L vs(9±3)μmol/L,0.81±0.17 vs 0.72±0.25,(42.8±10.7)μg/L vs(6.8±2.1)μg/L,(40.5±8.8)μg/L vs(4.6±1.1)μg/L,2.9±0.7 vs 1.7±0.6],while the level of UA was lower than the non-MS group[(296±58)μmol/L vs(343±95)μmol/L](P<0.01).Pearson analysis showed that the levels of Hcy and GAPDH were positively correlated with EDSS score,NSE,MBP(r=0.567,r=0.624,r=0.538,r=0.582,r=0.487,r=0.556,all P<0.01);UA was negatively correlated with EDSS score,NSE,MBP(r=-0.806,r=-0.713,r=-0.681,all P<0.01).According to ROC curve analysis,the sensitivity of Hcy in predicting neurological impairment in MS was 76.19%,the specificity was 80.25%,and the area under the curve(AUC)was 0.727(0.581-0.877);the sensitivity of UA in predicting neurological impairment in MS was 66.67%,the specificity was 74.07%,and the AUC was 0.661(0.517-0.783);the sensitivity of GAPDH in predicting neurological impairment in MS was 85.71%,the specificity was 86.42%,and the AUC was 0.837(0.713-0.935).Conclusion The levels of ser

关 键 词：多发性硬化 神经功能 同型半胱氨酸 尿酸 3-磷酸甘油醛脱氢酶 

分 类 号：R744.51[医药卫生—神经病学与精神病学]