CAJ | 학술논문

目的检测血清水通道蛋白4 (AQP4)抗体并评价其对视神经脊髓炎谱系疾病(NMOSDs)的意义. 方法选择自2007年5月至2012年5月天津医科大学总医院神经内科收治的中枢神经系统脱髓鞘疾病患者153例,其中NMOSDs患者利用细胞荧光免疫染色法(CBA)检测血清AQP4抗体,并对AQP4抗体阳性和AQP4抗体阴性的NMOSDs患者特点进行对比分析.结果 CBA检测AQP4抗体的敏感性为83.3％,特异性为100％.在AQP4抗体阳性的NMOSDs患者中,女性占78.8％,而在AQP4抗体阴性的患者中,女性仅占47.1％,两者相比差别有统计学意义(P=0.007); AQP4抗体阳性同时合并其他自身免疫抗体的NMOSDs患者首次发病EDSS为(5.9±2.0)分,单纯AQP4抗体阳性的NMOSDs患者扩展残疾状况评分量表(EDSS)为(4.2±1.9)分,比较差异有统计学意义(t=3.806,P=0.033);血清AQP4抗体在急性期呈阳性,缓解期呈阴性,且经各种免疫抑制剂治疗可由阳性逐渐转为阴性. 结论血清AQP4抗体可作为鉴别NMOSDs与多发性硬化的辅助诊断指标,并对判断NMOSDs疾病复发及治疗效果有一定的指导价值.
목적 검측혈청수통도단백4 (AQP4)항체병평개기대시신경척수염보계질병(NMOSDs)적의의. 방법 선택자2007년5월지2012년5월천진의과대학총의원신경내과수치적중추신경계통탈수초질병환자153례,기중NMOSDs환자이용세포형광면역염색법(CBA)검측혈청AQP4항체,병대AQP4항체양성화AQP4항체음성적NMOSDs환자특점진행대비분석.결과 CBA검측AQP4항체적민감성위83.3％,특이성위100％.재AQP4항체양성적NMOSDs환자중,녀성점78.8％,이재AQP4항체음성적환자중,녀성부점47.1％,량자상비차별유통계학의의(P=0.007); AQP4항체양성동시합병기타자신면역항체적NMOSDs환자수차발병EDSS위(5.9±2.0)분,단순AQP4항체양성적NMOSDs환자확전잔질상황평분량표(EDSS)위(4.2±1.9)분,비교차이유통계학의의(t=3.806,P=0.033);혈청AQP4항체재급성기정양성,완해기정음성,차경각충면역억제제치료가유양성축점전위음성. 결론 혈청AQP4항체가작위감별NMOSDs여다발성경화적보조진단지표,병대판단NMOSDs질병복발급치료효과유일정적지도개치.
Objective To test the level of aquaporin-4 (AQP4) antibody and assess the frequency and specificity of AQP4 antibodies in patients with neuromyelitis optica spectrum disorders (NMOSDs).Methods One hundred and fifty-three patients with demyelinating disease of the central nervous system,admitted to our hospital from May 2007 to May 2012,were chosen in our study; of them,102 had NMOSDs; AQP4 antibodies in the sera of these 102 patients were detected by cell-based immunofluorescence assay (CBA); the distinctive features of NMOSDs by autoantibodies status (AQP4 antibody-positive or antibody-negative) were analyzed retrospectively.Results The sensitivity and specificity of CBA assay for detecting AQP4 antibodies were 83.3％ and 100％,respectively.In patients with positive AQP4 antibodies,the female one took 78.8％,while in patients with negative AQP4 antibodies,the female one only took 28.6％; significant difference was noted between the two (P=0.007); the patients with both AQP4 antibody-positive and other systemic autoimmune diseases showed higher expanded disability status scale scores at the disease onset (5.9±2.0) as compared with the patients only with AQP4 antibody-positive (4.2±1.9,t=3.806,P=0.033); AQP4 antibody deduced even lost during the remission stage,and immunosuppressant medicine could remove the AQP4 antibody.Conclusion Testing for AQP4 antibodies is helpful for the differential diagnosis between NMOSDs and multiple sclerosis,and also useful for predicting the relapse and treating of NMOSDs.