CAJ | 학술논문

目的探讨视神经脊髓炎高危综合征患者血清尿酸水平与临床特征的关系.方法尿酶法检测51例急性期视神经脊髓炎高危综合征(34例长节段脊髓炎,17例视神经炎),48例视神经脊髓炎,45例神经科其他疾病,65名健康对照的血清尿酸水平.采用扩展残疾状态量表(EDSS)评价病情严重程度,MRI评估受累病灶,细胞免疫荧光法检测水通道蛋白4抗体水平.结果长节段脊髓炎组尿酸水平(189.84±85.65)μmol/L,视神经炎组(222.12±61.68)μmol/L,低于其他疾病组[(315.90±71.36)μmol/L]和健康对照组[(291.05±76.64)μmol/L,P＜0.01],与视神经脊髓炎[(219.19±76.47)μmol/L]比较差异无统计学意义.各组女性患者尿酸水平[(158.24±55.92)、(187.00±47.52)、(198.21±62.62)、(274.51±70.66)和(243.26±60.65)μmol/L]均低于男性组[(262.09±101.63)、(262.45±62.13)、(298.90±74.14)、(355.37±50.30)和(340.34±58.23)μmol/L,t=3.183、2.578、4.356、4.365、6.579,P＜0.05].高危综合征组患者不同病程组,水通道蛋白4抗体阳性、阴性组尿酸差异无统计学意义.长节段脊髓炎组尿酸水平与EDSS评分呈负相关(r=-0.714,P＜0.01).结论低尿酸可能与视神经脊髓炎高危综合征发病相关,且与长节段脊髓炎患者疾病严重程度有关.
목적 탐토시신경척수염고위종합정환자혈청뇨산수평여림상특정적관계.방법 뇨매법검측51례급성기시신경척수염고위종합정(34례장절단척수염,17례시신경염),48례시신경척수염,45례신경과기타질병,65명건강대조적혈청뇨산수평.채용확전잔질상태량표(EDSS)평개병정엄중정도,MRI평고수루병조,세포면역형광법검측수통도단백4항체수평.결과 장절단척수염조뇨산수평(189.84±85.65)μmol/L,시신경염조(222.12±61.68)μmol/L,저우기타질병조[(315.90±71.36)μmol/L]화건강대조조[(291.05±76.64)μmol/L,P＜0.01],여시신경척수염[(219.19±76.47)μmol/L]비교차이무통계학의의.각조녀성환자뇨산수평[(158.24±55.92)、(187.00±47.52)、(198.21±62.62)、(274.51±70.66)화(243.26±60.65)μmol/L]균저우남성조[(262.09±101.63)、(262.45±62.13)、(298.90±74.14)、(355.37±50.30)화(340.34±58.23)μmol/L,t=3.183、2.578、4.356、4.365、6.579,P＜0.05].고위종합정조환자불동병정조,수통도단백4항체양성、음성조뇨산차이무통계학의의.장절단척수염조뇨산수평여EDSS평분정부상관(r=-0.714,P＜0.01).결론 저뇨산가능여시신경척수염고위종합정발병상관,차여장절단척수염환자질병엄중정도유관.
Objective To investigate serum uric acid (UA) levels and related clinical features in patients with high risk syndrome of neuromyelitis optica. Methods UA levels were measured in 51 patients with high risk syndrome of neuromyelitis optica including 34 with longitudinally extensive transverse myelitis (LETM) and 17 with optic neuritis (ON), 48 with neuromyelitis optica (NMO), 45 with other neurological diseases (OND) and 65 with healthy controls (HC). The disability severity was assessed by the expanded disability status scale (EDSS). Spinal lesions were viewed by MRI. Serum aquaporin-4(AQP4) antibody was tested in cell based immunofluorescence assay. Results Serum UA levels in LETM ( ( 189. 84 ±85. 65) μmol/L) and ON patients ( (222. 12 ±61.68) μmol/L) were significantly lower than that in OND ((315.90±71.36) μ mol/L) and HC ((291.05 ±76.64) μ mol/L) subjects (P＜0.01). No difference was found between LETM, ON and NMO groups. UA levels were significantly lower in females ( ( 158.24 ±55.92), (187.00±47.52), (198.21 ±62.62), (274.51 ±70.66)and (243.26±60.65) μmol/L)than in males ( ( 262. 09 ± 101.63 ), ( 262. 45 ± 62. 13 ), ( 298.90 ± 74. 14 ), ( 355.37 ± 50. 30 ) and (340. 34 ±58. 23) μmol/L) in all groups (t=3. 183, 2.578, 4.356, 4.365 and 6.579, all P＜0.05).UA levels in patients with high risk syndrome of NMO were not correlated with mono or relapse course,duration or status of serum AQP4 antibody. UA were negatively correlated with EDSS in patients with LETM (r= -0.714, P＜0.01). Conclusion Lower serum UA levels were found in patients with high risk syndrome of NMO and related to more severe symptoms in LETM group.