血清AQP4-Ab和细胞因子在视神经脊髓炎谱系疾病中的表达水平及临床意义

摘要

Objective To explore the expressions of aquaporin-protein antibody (AQP4-Ab) and cytokines in serum of patients with neuromyelitis optica spectrum disorders (NMOSD),and to analyze their relationship with the clinical features and their significance.Methods 77 patients with NMOSD treated at our hospital from January,2016 to December,2017 were selected;and 20 healthy persons during the same period were selected as a control group.The expression of AQP4-Ab and the contents of cytokines (IL-25,IL-31,and IL-1 β) in serum of all the objects were measured.The relationship between the indicators and the clinical features,as well as the changes of indicators in the occurrence and development of the disease,were analyzed.Results The positive rate of AQP4-Ab in the NMOSD patients was 66.23％(51/77);and the initial symptoms of NMOSD were unrelated to the expression of AQP4-Ab (P ＞ 0.05).The proportion of women and the incidence of optic nerve damage in the AQP4-Ab-positive group were significantly higher than those in the AQP4-Ab-negative group (86.27％ vs.61.54％ and 74.51％ vs.42.31％,both P ＜ 0.05).The EDSS was significantly higher in the AQP4-Ab-positive group than in the AQP4-Ab-negative group [(4.65±1.51) vs.(3.23±1.24),P ＜ 0.05].Compared to healthy controls,the serum levels of IL-25 and IL-31 were significantly higher in the patients with NMOSD than in the control group [(30.95±1.86) pg/ml vs.(21.60±3.23) pg/ml and (106.05±3.84) pg/ml vs.(74.30±2.90) pg/ml];and they were positively correlated(r=0.847,P=0.000).Conclusion AQP4-Ab are highly expressed in NMOSD.Patients with NMOSD who are positive in AQP4-Ab are in a serious condition.The serum levels of IL-25 and IL-31 in patients with NMOSD are significantly higher and correlated with each other.%目的 探究视神经脊髓炎谱系疾病(NMOSD)患者血清中水通道蛋白抗体(AQP4-Ab)和细胞因子的表达,分析其与临床特征的关系及意义.方法 选取2016年1月至2017年12月就诊于本院眼科的77例NMOSD患者及20例健康者作为对照组.检测所有患者血清AQP4-Ab的表达及细胞因子(IL-25、IL-31、IL-1β)的含量,并分析二者与临床特征的关系及疾病的发生发展中的变化.结果 NMOSD中AQP4-Ab的阳性率为66.23％(51/77),NMOSD首发症状与AQP4-Ab的表达无关,差异无统计学意义(P＞ 0.05);AQP4-Ab阳性组女性所占比例、视神经损害发生率86.27％、74.51％,均明显高于AQP4-Ab阴性组61.54％、42.31％,差异均有统计学意义(均P＜0.05),且AQP4-Ab阳性组的疾病严重程度评分(4.65±1.51)分,明显高于AQP4抗体阴性组(3.23±1.24)分,差异有统计学意义(P＜ 0.05);NMOSD患者血清IL-25、IL-31分别为(30.95±1.86) pg/ml、(106.05±3.84)pg/ml,明显高于对照组(21.60±3.23) pg/ml、(74.30±2.90) pg/ml,差异均有统计学意义(均P＜0.05),且血清中IL-25与IL-31的水平呈正相关(r=0.847,P=0.000).结论 NMOSD中AQP4-Ab阳性的患者病情较重,IL-25、IL-31在NMOSD患者血清中水平明显增高且具有一定的相关性.