视神经脊髓炎谱系病病人血清AQP4-IgG水平及其临床意义

目的:探讨视神经脊髓炎谱系病(NMOSD)病人血清水通道蛋白4-抗体(AQP4-IgG)水平与临床特征的相关性.方法:选取确诊的NMOSD病人38例,记录扩展残疾状态量表(EDSS)评分,采用间接免疫荧光法检测血清AQP4-IgG水平,分析其水平与临床症状、影像学表现的相关性.结果:AQP4-IgG抗体阳性组23例(60.5%),阴性组15例(39.5%),阳性组EDSS评分显著高于阴性组(P<0.05);Spearman相关性分析发现,血清AQP-4 IgG与EDSS评分、脊髓受累节段数均呈正相关关系(P<0.01).抗体阳性组3例复发,阴性组无复发病例.结论:NMOSD AQP4-IgG抗体阳性病人神经功能缺损症状重,且抗体水平越高,脊髓受累节段多,预后较差,较AQP4-IgG抗体阴性病人易复发.

Serum levels of AQP4-IgG in patients with neuromyelitis optica spectrum disorders and its clinical significance

Objective:To investigate the correlation between the serum level of aquaporin 4-antibody(AQP4-IgG) and the clinical feature in patients with neuromyelitis optica spectrum disorders( NMOSD) . Methods:The score of the expanded disability status scale ( EDSS) and serum levels of AQP4-IgG detected by indirect immunofluorescence assay in 38 NMOSD cases were investigated. The correlations between serum level of AQP4-IgG,clinical symptom,image manifestation were analyzed. Results:The positive AQP4-IgG antibody in 23 cases(60. 5%) and AQP4-IgG negative antibody in 15 cases(39. 5%) were identified,and the EDSS score in positive group was significantly higher than that in negative group(P <0. 05). Spearman correlation analysis showed that the serum level of AQP4-IgG antibody was positive correlation with the EDSS score and lesion segment of spinal cord(P<0. 01). Three cases recurred in positive group,and no case recurred in negative group. Conclusions:The nerve impairment in NMOSD patients with AQP4-IgG antibody positive is severe. The higher the antibody and more spinal cord lesion are, the poorer the prognosis is. The patient with AQP4-IgG antibody negative is easy to recur.