本文關(guān)鍵詞：視神經(jīng)脊髓炎星形膠質(zhì)細(xì)胞損害與神經(jīng)功能障礙關(guān)系研究　出處：《廣西醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

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【摘要】：目的探索AQP4-Ab. GFAP. ApoE. IL-6. IL-10. TNF-a是否與視神經(jīng)脊髓炎(NMO)的發(fā)病機(jī)制有關(guān),與NMO患者功能缺損的嚴(yán)重程度相關(guān)性,以及與糖皮質(zhì)激素治療效果的關(guān)系。方法設(shè)立NMO組(n=30,處于急性期7天內(nèi))和對(duì)照組(n=28),采用雙抗體夾心酶聯(lián)免疫吸附法(Enzyme-Linked Immunosorbent Assay, ELISA)檢測(cè)兩組腦脊液(CSF)和血清中的AQP4-Ab、GFAP、ApoE、IL-6. IL-10、TNF-a的水平進(jìn)行檢測(cè),比較兩組數(shù)據(jù)的差異。NMO 組 CSF GFAP、 ApoE. IL-6. IL-10. TNF-a的水平與CSF AQP4-Ab水平進(jìn)行相關(guān)性分析,同時(shí)將CSF AQP4-Ab、GFAP. ApoE. IL-6、IL-10、TNF-a水平與急性期EDSS 評(píng)分 (Expanded Disability Status Scale)進(jìn)行相關(guān)性分析。檢測(cè)糖皮質(zhì)激素治療前后NMO組血清中各個(gè)指標(biāo)變化,并對(duì)糖皮質(zhì)激素治療前后EDSS評(píng)分進(jìn)行比較。結(jié)果NMO組CSF及激素治療前血清的AQP4-Ab. GFAP. IL-6水平均較對(duì)照組高(P0.05),ApoE. IL-10水平較對(duì)照組低(P0.05),TNF-α水平和對(duì)照組之間的差異無統(tǒng)計(jì)學(xué)意義(P0.05)；NMO組CSF AQP-4Ab.IL-10水平均較血清低(P0.05),GFAP.ApoE. IL-6. TNF-a水平較血清高(P0.05); CSF GFAP. IL-6水平與CSF AQP4-Ab水平呈正相關(guān)(P0.05), ApoE. IL-10水平與CSF AQP4-Ab水平呈負(fù)相關(guān)(P0.05),TNF-α水平與CSF AQP4-Ab水平無明顯相關(guān)(P0.05); CSF AQP4-Ab.GFAP、IL-6水平與急性期EDSS評(píng)分呈正相關(guān)(P0.05), ApoE. IL-10水平與急性期EDSS評(píng)分呈負(fù)相關(guān)(P0.05),TNF-a水平與急性期EDSS評(píng)分無明顯相關(guān)(P0.05)；糖皮質(zhì)激素治療前后NMO組血清AQP4-Ab、 GFAP、ApoE、IL-6、IL-10、TNF-α水平差異無統(tǒng)計(jì)學(xué)意義(P0.05),治療后EDSS評(píng)分較治療前低(P0.05)。結(jié)論1.檢測(cè)AQP4-Ab的水平對(duì)NMO疾病的診斷及疾病嚴(yán)重程度有重要的預(yù)示作用,為臨床治療NMO提供依據(jù)；2.NMO急性期GFAP、IL-6可增高,CSF GFAP、IL-6與CSF AQP4-Ab、NMO功能缺損程度有關(guān),預(yù)示有可能參與NMO的發(fā)病機(jī)制,為疾病的觀察及藥物治療NMO的療效判斷提供理論依據(jù)；3.NMO急性期ApoE、IL-10降低,CSF ApoE、IL-10與CSF AQP4-Ab、NMO的功能缺損程度有關(guān),提示ApoE、IL-10可用于觀察病情預(yù)后,外源性補(bǔ)充ApoE、IL-10可能成為治療NMO的研究切入點(diǎn)；4.NMO在糖皮質(zhì)激素治療后EDSS評(píng)分較前低,可以提示激素治療的神經(jīng)保護(hù)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- 偽 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- 偽 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- 偽 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.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R744.52

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