运动神经元病患者血清和脑脊液中NSE和GM1抗体测定及其临床意义

摘要

Objective To study the levels of neuron-specific enolase (NSE)and antibody against GM1 ganglioside in sera and CSF of patients with motor neuron disease(MND) and to evaluate their clinical significance. Methods The levels of NSE and GM1 antibody in sera and CSF of 30 patients with MND were analyzed with enzyme-linked immunosorbent assays (ELISA). Results The levels of NSE in both CSF and sera of MND pati-ents were significantly higher than normal control(NC) group(P<0.01,P<0.05 respectively), only in CSF the NSE level of MND group was significantly higher than other neurological diseases (OND) group(P<0.01); Among different types of MND, the NSE level in CSF of PSMA type was significantly higher than the other types(P<0.01),while it was not the case of sera(P>0.05); In both CSF and sera, the positivity of IgM-and IgG-GM1 antibody of MND pati-ents were significantly higher than OND and NC group(P<0.01);In addition, the NSE level in the CSF was closely correlated to that in serum of MND patients(r=0.502, P<0.01),and there was also a significant correlation between NSE level and GM1 antibody in CSF of MND patients (r=0.475, P<0.05). Conclusions The levels of NSE and GM1 antibody in CSF may reflect the extent and territory of the neuron damage in motor system of patients with MND; We speculate that this damage might be related tothe GM1 antibody-mediated humoral immune responses in central nervous system.%目的 通过测定运动神经元病(MND)患者血清和脑脊液(CSF)中神经元特异性烯醇化酶(NSE)和GM1抗体，初步探讨其临床意义。方法 应用ELISA法测定30例MND患者血清和CSF中NSE和GM1抗体水平。结果 MND组CSF和血清中NSE含量均明显高于NC组(P<0.01,P<0.05)，而仅在CSF中NSE含量高于OND组(P<0.01)；临床分型以运动神经元损害为主的进行性脊肌萎缩症(PSMA)患者CSF中NSE含量明显高于其他组(P<0.01)，而血清中NSE水平在各临床类型间差异并不明显(P>0.05)；MND患者血清和CSF中不论是IgM型或是IgG型GM1抗体阳性率均明显高于OND组和NC组(P均<0.01)；MND患者血清和CSF配对样品NSE水平有较好的相关性(r=0.502,P<0.01)，MND患者CSF中NSE水平与GM1抗体亦有相关性(r=0.475,P<0.05)，其余各组之间均未见明显相关性(P>0.05)。结论 MND患者CSF中NSE和GM1抗体水平可以反映运动系统神经元损害的程度和范围；推测这种神经元的损伤可能与GM1抗体介导的中枢神经系统免疫反应有关。