尿酸与多发性硬化发生和复发的关系

摘要

目的 分析多发性硬化(multiple sclerosis,MS)患者血清尿酸水平的变化,探讨尿酸在MS发生和复发中的作用.方法 收集95例确诊的MS患者的临床、影像学、治疗和血生化检查的资料,同时收集性别、年龄匹配的97名健康查体者的血生化检查结果,分析血尿酸水平与MS的关系.结果 (1)MS患者血尿酸水平较对照组明显降低 (195.6±65.0)μmol/L vs.(256.1±48.0)μmol/L,P＜0.01];按性别分层分析,女性患者血尿酸水平较对照组显著降低 (179.8±53.7)μmol/L vs.(253.2±48.3)μmol/L,P＜0.01),男性患者血尿酸水平与对照组比较无统计学变化.(2)女性MS患者活动期[(171.1±52.4)μmol/L]和缓解期[(207.4±49.7)μmol/L]的血尿酸水平均明显低于正常对照组(均P＜0.01),且活动期MS血尿酸水平较缓解期进一步降低(P＜0.05).(3)血尿酸水平与发病年龄、病程和EDSS评分无相关性.结论 血尿酸水平降低可能与MS的发生和复发有关,其机制可能是血尿酸水平的降低削弱了患者对氧化应激的承受能力.%Objective To investigate the relationship between serum uric acid level and the development and relapse of multiple sclerosis (MS). Methods We collected the clinical data, including clinical manifestations, images, therapy, and blood chemicals, in 95 MS patients and blood chemicals in 97 healthy controls. Results (1) Compared with healthy controls, serum uric acid level was reduced significantly in MS patients [ (195. 6± 65. 0) μmol/L vs (256. 1±48. 0) μmol/L, P<0. 01]; Stratified analysis by sex showed that the difference was due to the serum uric acid reduction in female MS patients [ (179. 8 + 53. 7) μmol/L in MS vs (253. 2±48. 3) μmol/L in controls, P<0. 01)], whereas, no significant change in male MS patients. (2) In the female MS patients, the serum uric acid levels in the active and the remitting were (171. 1 + 52. 4) μmol/L and (207. 4 + 49. 7) μmol/L, respectively, and both were significantly lower than that in controls [ (253. 2 + 48. 3) μmol/L, P<0. 01]. Furthermore, the decrease was more pronounced in the relapsing when compared with the remitting MS patients (P<0. 05). (3) Serum uric acid level was independent of MS onset age, MS duration, and EDSS. Conclusions The lower serum uric acid level may contribute to the development and relapse of MS in female by impairing the prevention against oxidative and nitrosative stress in MS.