CAJ | 학술논문

目的观察急性期多发性硬化(MS)患者血浆和脑脊液中趋化因子CXCL10水平的动态变化规律及其与临床神经功能障碍的相关性,探讨其对疾病活动性的判定价值.方法收集急性期MS患者、缓解期MS患者及健康对照各53例,神经系统非炎性疾病(NIND)32例,采用酶联免疫吸附试验法检测血浆和脑脊液中CXCL10水平,并进行扩展残疾状况评分量表(EDSS)评分.结果 (1)与急性期初期相比,急性期MS组患者第2、4周血浆CXCL10水平[(601±365)、(575±297)pg/ml]明显升高(t=-2.898、-2.651,P=0.001、0.003);第4周脑脊液中CXCL10水平[(1807±803)pg/ml]与急性期初期比较差异无统计学意义.(2)急性期初期MS组血浆CXCL10水平明显高于缓解期MS组[(287±118)pg/ml,t=3.555,P=0.001]和健康对照组[(248±130)pg/ml,t=4.895,P=0.000].(3)急性期MS组脑脊液CXCL10水平[(1774±604)pg/ml]明显高于NIND组[(122±114)pg/ml,t=15.192,P=0.000].(4)急性期MS组患者血浆与脑脊液中CXCL10水平间存在相关性(r=0.792,P=0.001);脑脊液CXCL10水平与同期EDSS评分之间存在相关性(r=0.526,P=0.002).结论 (1)MS患者血浆中CXCL10水平对判断疾病活动性有一定的参考价值.(2)急性期MS患者血浆CXCL10水平能在一定程度上反映其在脑脊液中的水平.(3)检测急性期MS患者脑脊液CXCL10水平对判断临床功能障碍程度有一定的参考价值.
목적 관찰급성기다발성경화(MS)환자혈장화뇌척액중추화인자CXCL10수평적동태변화규률급기여림상신경공능장애적상관성,탐토기대질병활동성적판정개치.방법 수집급성기MS환자、완해기MS환자급건강대조각53례,신경계통비염성질병(NIND)32례,채용매련면역흡부시험법검측혈장화뇌척액중CXCL10수평,병진행확전잔질상황평분량표(EDSS)평분.결과 (1)여급성기초기상비,급성기MS조환자제2、4주혈장CXCL10수평[(601±365)、(575±297)pg/ml]명현승고(t=-2.898、-2.651,P=0.001、0.003);제4주뇌척액중CXCL10수평[(1807±803)pg/ml]여급성기초기비교차이무통계학의의.(2)급성기초기MS조혈장CXCL10수평명현고우완해기MS조[(287±118)pg/ml,t=3.555,P=0.001]화건강대조조[(248±130)pg/ml,t=4.895,P=0.000].(3)급성기MS조뇌척액CXCL10수평[(1774±604)pg/ml]명현고우NIND조[(122±114)pg/ml,t=15.192,P=0.000].(4)급성기MS조환자혈장여뇌척액중CXCL10수평간존재상관성(r=0.792,P=0.001);뇌척액CXCL10수평여동기EDSS평분지간존재상관성(r=0.526,P=0.002).결론 (1)MS환자혈장중CXCL10수평대판단질병활동성유일정적삼고개치.(2)급성기MS환자혈장CXCL10수평능재일정정도상반영기재뇌척액중적수평.(3)검측급성기MS환자뇌척액CXCL10수평대판단림상공능장애정도유일정적삼고개치.
Objective To investigate the evolution of CXCL10 in blood plasma and cerebrospinal fluid (CSF) during relapses of multiple sclerosis (MS),and the correlation between these and the clinical neurological dysfunction.Methods Fifty-three patients with definite MS during relapsing state (relapsing MS group) diagnosed by the McDonald criteria;fifty-three patients with definite MS during remitting state ( remitting MS group);thirty-two patients with non-inflammatory neurologic disease ( NIND group) and fiftythree healthy controls (NC group) were enrolled in the study.Each patient clinical status was evaluated with the Expanded Disability Status Scale ( EDSS).Plasma and CSF levels were analyzed by enzyme-linked immunoassay.Results ( 1 ) The CXCL10 level in plasma in relapsing MS group elevated significantly between the 2nd ( (601 ± 365 ) pg/ml,t = - 2.898,P = 0.001) and the 4th ( (575 ± 297 ) pg/ml,t = -2.651,P=0.003) week after relapsing;GXL10 in CSF (n =32) did not changed significantly in the 4th week after relapsing( (1807 ±803) pg/ml).(2) The CXCL10 level in plasma in relapsing MS group were significantly higher than that in the healthy control group ((248±130) pg/ml,(=4.895,P=0.000) and remitting MS group ((287 ±118) pg/ml,t = 3.555,P = 0.001 ).( 3 ) The CXCL10 level in CSF in relapsing MS group (( 1774 ± 604) pg/ml) was significantly higher than that in NIND group ( ( 122 ± 114) pg/ml,t= 15.192,P =0.000).(4) The CXCL10 level in plasma in relapsing MS group had correlation with that in CSF (r=0.792,P=0.001).The CXCL10 level in CSF in relapsing MS group had correlation with EDSS scores (r = 0.526,P = 0.002 ).Conclusions The CXCL10 level in plasma might be implemented as a paraclinical marker of disease activity in MS.The CXCL10 level in plasma of MS may be relevant to that in CSF.The CXCL10 level in CSF of MS may indicate the clinical neurological dysfunction.