CAJ | 학술논문

目的：观察肝肾阴虚型视神经脊髓炎（ neuromyelitis optica ，NMO）与多发性硬化（ mul－tiple sclerosis，MS）患者血清免疫球蛋白和补体的表达水平。方法观察2012年10月至2014年6月就诊于首都医科大学附属北京天坛医院中医科门诊的NMO患者20例，作为NMO组，MS患者10例，作为MS组；11例健康志愿者作为对照组。记录NMO组及MS组患者发病年龄、病程及复发次数，并进行扩展残疾量表评分（Expanded Disability Status Scale，EDSS）。采用免疫比浊法定量测定三组血清中补体成分3（C3）、补体成分4（C4）、免疫球蛋白G（IgG）、免疫球蛋白A（IgA）及免疫球蛋白M（IgM）水平。结果与MS组比较，NMO组患者的病程长、复发次数多（P＜0．05），其EDSS评分较高、发病年龄较早，但差异无统计学意义（ P＞0．05）。 NMO组患者补体C3水平与对照组比较显著降低（P＜0．05），亦低于MS组（P＜0．01），而MS组与对照组间无显著差异（P＞0．05）。 NMO患者补体C3水平与发病年龄、病程、复发次数及EDSS评分均无显著相关性（P＞0．05）。 NMO组血清补体C4水平略低于对照组，差异无统计学意义（P＞0．05），但显著低于MS组（P＜0．01），MS组与对照组间无显著差异（ P＞0．05）。 NMO组、MS组患者的IgG、IgA、IgM水平与对照组比较均无显著差异（P＞0．05），两组间差异亦无统计学意义（P＞0．05）。结论 NMO的发病过程中补体C3激活起到了重要作用，在缓解期部分患者仍存在补体水平降低，这对于鉴别NMO与MS具有一定意义。
목적：관찰간신음허형시신경척수염（ neuromyelitis optica ，NMO）여다발성경화（ mul－tiple sclerosis，MS）환자혈청면역구단백화보체적표체수평。방법관찰2012년10월지2014년6월취진우수도의과대학부속북경천단의원중의과문진적NMO환자20례，작위NMO조，MS환자10례，작위MS조；11례건강지원자작위대조조。기록NMO조급MS조환자발병년령、병정급복발차수，병진행확전잔질량표평분（Expanded Disability Status Scale，EDSS）。채용면역비탁법정량측정삼조혈청중보체성분3（C3）、보체성분4（C4）、면역구단백G（IgG）、면역구단백A（IgA）급면역구단백M（IgM）수평。결과여MS조비교，NMO조환자적병정장、복발차수다（P＜0．05），기EDSS평분교고、발병년령교조，단차이무통계학의의（ P＞0．05）。 NMO조환자보체C3수평여대조조비교현저강저（P＜0．05），역저우MS조（P＜0．01），이MS조여대조조간무현저차이（P＞0．05）。 NMO환자보체C3수평여발병년령、병정、복발차수급EDSS평분균무현저상관성（P＞0．05）。 NMO조혈청보체C4수평략저우대조조，차이무통계학의의（P＞0．05），단현저저우MS조（P＜0．01），MS조여대조조간무현저차이（ P＞0．05）。 NMO조、MS조환자적IgG、IgA、IgM수평여대조조비교균무현저차이（P＞0．05），량조간차이역무통계학의의（P＞0．05）。결론 NMO적발병과정중보체C3격활기도료중요작용，재완해기부분환자잉존재보체수평강저，저대우감별NMO여MS구유일정의의。
Objective To observe the levels of complement and immunoglobulin in serum of neu-romyelitis optica and multiple sclerosis patients with deficiency of kidney-liver yin syndrome .Methods 20 patients with NMO visiting at traditional medicine Department of Beijing Tiantan hospital affiliated capital medical university during 10,2012 to 06,2014 were divided into NMO group , and 10 patients with MS were divided into MS group ,11 healthy volunteer were in control group .The age of onset , duration , frequency of recurrence and Expanded Disability Scale score ( EDSS score ) of NMO and MS patients were recorded . The levels of complement component 3 (C3), complement component 4 (C4), immunoglobulin G (IgG), immunoglobulin A (IgA) and immunoglobulin M (IgM) in serum were detected by Immunoturbidimetry . Results NMO patients had longer duration , more recurrence compared with the MS group ( P<0.05 ) , and their EDSS score was higher , age of onset was earlier , but the difference was not statistically significant (P>0.05).Complement 3 levels in serum of patients with NMO group were significantly lower than control group (P<0.05), and also lower than MS group (P<0.01), but there was no significant difference be-tween the MS group and the control group ( P>0.05) .The complement 3 levels of NMO patients and the age of onset, duration, recurrence, EDSS scores were not significantly correlated (P>0.05).The serum complement 4 levels in NMO group were slightly lower than the control group (P>0.05), but significantly lower than MS group (P<0.01), there was no significant difference between the MS group and the control group(P>0.05) .The IgG, IgA, IgM levels between three groups were not significantly different (P>0.05).Conclusion Complement 3 activation plays an important role in the pathogenesis of NMO .The complement levels of some patients are still reduced even during remission , which has some significance for the identification of NMO and MS .