视神经脊髓炎星形胶质细胞损害与神经功能障碍关系研究

发布时间：2018-01-16 07:37

本文关键词：视神经脊髓炎星形胶质细胞损害与神经功能障碍关系研究　出处：《广西医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的探索AQP4-Ab. GFAP. ApoE. IL-6. IL-10. TNF-a是否与视神经脊髓炎(NMO)的发病机制有关,与NMO患者功能缺损的严重程度相关性,以及与糖皮质激素治疗效果的关系。方法设立NMO组(n=30,处于急性期7天内)和对照组(n=28),采用双抗体夹心酶联免疫吸附法(Enzyme-Linked Immunosorbent Assay, ELISA)检测两组脑脊液(CSF)和血清中的AQP4-Ab、GFAP、ApoE、IL-6. IL-10、TNF-a的水平进行检测,比较两组数据的差异。NMO 组 CSF GFAP、 ApoE. IL-6. IL-10. TNF-a的水平与CSF AQP4-Ab水平进行相关性分析,同时将CSF AQP4-Ab、GFAP. ApoE. IL-6、IL-10、TNF-a水平与急性期EDSS 评分 (Expanded Disability Status Scale)进行相关性分析。检测糖皮质激素治疗前后NMO组血清中各个指标变化,并对糖皮质激素治疗前后EDSS评分进行比较。结果NMO组CSF及激素治疗前血清的AQP4-Ab. GFAP. IL-6水平均较对照组高(P0.05),ApoE. IL-10水平较对照组低(P0.05),TNF-α水平和对照组之间的差异无统计学意义(P0.05)；NMO组CSF AQP-4Ab.IL-10水平均较血清低(P0.05),GFAP.ApoE. IL-6. TNF-a水平较血清高(P0.05); CSF GFAP. IL-6水平与CSF AQP4-Ab水平呈正相关(P0.05), ApoE. IL-10水平与CSF AQP4-Ab水平呈负相关(P0.05),TNF-α水平与CSF AQP4-Ab水平无明显相关(P0.05); CSF AQP4-Ab.GFAP、IL-6水平与急性期EDSS评分呈正相关(P0.05), ApoE. IL-10水平与急性期EDSS评分呈负相关(P0.05),TNF-a水平与急性期EDSS评分无明显相关(P0.05)；糖皮质激素治疗前后NMO组血清AQP4-Ab、 GFAP、ApoE、IL-6、IL-10、TNF-α水平差异无统计学意义(P0.05),治疗后EDSS评分较治疗前低(P0.05)。结论1.检测AQP4-Ab的水平对NMO疾病的诊断及疾病严重程度有重要的预示作用,为临床治疗NMO提供依据；2.NMO急性期GFAP、IL-6可增高,CSF GFAP、IL-6与CSF AQP4-Ab、NMO功能缺损程度有关,预示有可能参与NMO的发病机制,为疾病的观察及药物治疗NMO的疗效判断提供理论依据；3.NMO急性期ApoE、IL-10降低,CSF ApoE、IL-10与CSF AQP4-Ab、NMO的功能缺损程度有关,提示ApoE、IL-10可用于观察病情预后,外源性补充ApoE、IL-10可能成为治疗NMO的研究切入点；4.NMO在糖皮质激素治疗后EDSS评分较前低,可以提示激素治疗的神经保护作用。
[Abstract]:Objective to investigate whether AQP4-Ab.GFAP.ApoE.IL-10.IL-10. TNF-a is related to the pathogenesis of optic neuromyelitis (NMO). Methods NMO group (n = 30, within 7 days of acute phase) and control group (n = 28) were established. Enzyme-Linked Immunosorbent Assay was detected by double antibody sandwich enzyme-linked immunosorbent assay (Elisa). Serum AQP4-AbGFAPP ApoE IL-6. IL-10 and TNF-a were detected by ELISA. Compare the difference between the two groups. CSF GFAP of NMO group. The correlation between the level of ApoE.IL-6.IL-10.The level of CSF AQP4-Ab and the level of CSF AQP4-Ab was analyzed. GFAP.ApoE.IL-6 IL-10. TNF-a level and EDSS score in acute phase: expanded Disability Status scale). After glucocorticoid therapy, the changes of each index in serum of NMO group were detected. Results the levels of CSF and AQP4-Ab.GFAP. IL-6 in serum of NMO group were higher than those of control group before and after glucocorticoid treatment. P0.05). The level of ApoE.TNF- 伪 was lower than that of control group (P 0.05) and there was no significant difference between control group and control group (P 0.05). The level of CSF AQP-4Ab.IL-10 in NMO group was lower than that in serum (P 0.05). The level of GFAP.ApoE.IL-6. TNF-a was higher than that of serum (P 0.05). CSF GFAP. IL-6 level was positively correlated with CSF AQP4-Ab level (P0.05). The level of Apo E. IL-10 was negatively correlated with the level of CSF AQP4-Ab (P 0.05). There was no significant correlation between TNF- 伪 level and CSF AQP4-Ab level. The level of IL-6 in CSF AQP4-Ab.GFAPP was positively correlated with EDSS score in acute stage (P 0.05). There was no significant correlation between ApoE. IL-10 level and EDSS score in acute stage (P 0.05) and EDSS score in acute stage (P 0.05). Before and after glucocorticoid treatment, there was no significant difference in serum AQP4-Ab, GFAPAP-ApoEP-IL-6 and IL-10 TNF- 伪 levels in NMO group (P 0.05). The EDSS score after treatment was lower than that before treatment (P 0.05). Conclusion 1. Detecting the level of AQP4-Ab plays an important role in the diagnosis and severity of NMO disease. 2. To provide the basis for clinical treatment of NMO; 2. The level of IL-6 in CSF AQP4-AbNMO was related to the degree of functional defect. It may be involved in the pathogenesis of NMO and provide a theoretical basis for the observation of the disease and the judgment of the curative effect of drug therapy on NMO. 3. The decrease of IL-10 in CSF during acute phase is related to the degree of functional impairment of CSF AQP4-Abnmo, suggesting that ApoE. IL-10 can be used to observe the prognosis of the disease. Exogenous supplement of ApoE IL-10 may be the entry point for the treatment of NMO. 4. The EDSS score after glucocorticoid therapy was lower than that before, suggesting the neuroprotective effect of glucocorticoid therapy.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R744.52

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