视神经脊髓炎血浆纤维蛋白原水平及临床相关性分析
发布时间：2018-03-07 17:24
本文选题：视神经脊髓炎 切入点：多发性硬化 出处：《山西医科大学》2017年硕士论文 论文类型：学位论文
【摘要】：目的:纤维蛋白原(FIB)是重要的凝血蛋白,在血脑屏障破坏后沉积于中枢神经系统,引起适应性免疫反应,诱导外周炎性细胞浸润并导致中枢神经系统脱髓鞘。探讨视神经脊髓炎(NMO)发病急性期患者血浆FIB水平并分析其与疾病首发年龄、疾病病程、复发次数、疾病的严重程度及受累脊髓节段等临床特点的相关性。方法:收集发病急性期NMO患者59例、复发缓解型多发性硬化(RRMS)患者56例、急性脊髓炎(AM)患者9例及19例良性发作性位置性眩晕(BPPV)患者为对照组的清晨空腹静脉血,分别测定血浆纤维蛋白原(FIB)、凝血酶原时间(PT),活化部分凝血酶时间(APTT)、凝血酶时间(TT)水平,分析各指标水平与患者临床特点的相关性。结果:(1)NMO发病急性期,患者血浆FIB水平显著高于对照组(P㩳0.0001);(2)NMO发病急性期,患者血浆FIB水平显著高于RRMS组(P㩳0.0001),但与AM组相比无差异(P=0.444);(3)AM组血浆FIB水平与RRMS组相比差异具有统计学意义(P=0.001),与对照组相比(P=0.003);(4)RRMS组血浆FIB水平与对照组相比无显著性差异;(5)NMO组、RRMS组及AM组血浆PT水平与对照组相比差异具有统计学意义(P=0.029,P=0.001,P=0.032),三组间比较无统计学差异;(6)NMO组与RRMS组相比血浆APTT水平具有显著性差异(P=0.005),RRMS组血浆APTT水平高于AM组及对照组(P=0.007,P=0.018);(7)RRMS组血浆TT水平高于AM组及对照组(P=0.025,P=0.035);(8)采用EDSS评分量表评估疾病严重程度,NMO组急性期血浆FIB水平与EDSS分值显著相关(P㩳0.0001,r=0.561),与患者发病年龄呈正相关(P=0.008,r=0.340);(9)RRMS组FIB水平与EDSS分值显著相关(P=0.0024,r=0.302),与疾病病程正相关(P=0.013,r=0.329)。结论:NMO发病急性期血浆FIB水平升高并与疾病严重程度密切相关,血浆FIB水平越高,提示患者病情越重。
[Abstract]:Objective: fibrinogen (FIB) is an important clotting protein in the blood brain barrier damage after deposition in the central nervous system, causing the adaptive immune response, induced by peripheral inflammatory cell infiltration and cause central nervous system demyelinating. Discussion of neuromyelitis optica (NMO) incidence of acute plasma levels of FIB and compare it with disease onset age, disease duration, recurrence times, correlation between the clinical features of the severity of the disease and the involved spinal cord segments etc.. Methods: collected 59 cases of acute stage NMO patients with relapsing remitting multiple sclerosis (RRMS) in 56 patients, acute myelitis (AM) in 9 cases and 19 cases of benign paroxysmal positional vertigo (BPPV) in patients with fasting venous blood as control group, respectively. The determination of plasma fibrinogen (FIB), prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) level, the level of indicators and analysis 鎮ｈ，
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