视神经脊髓炎谱系疾病患者血CD4细胞百分比与肢体伤残的相关性分析

摘要

Objective To explore the association between the whole blood CD4 cell percentage and physical disability in patients with neuromyelitis optica spectrum disorders (NMOSD).Method Clinical and biochemical data of 58 patients with NMOSD were retrospectively analyzed in Department of Neurology at Shanghai First Rehibilitation Hostipal and Renji Hospital from January 2015 to June 2016. According to Expanded Disability Status Scale(EDSS), NMOSD patients were divided into groups with independent walking and assisted walking, and their clinical and biochemical characteristics were compared between the two groups,then the association between whole blood CD4 cell percentage and physical disability was analyzed.Results Between the groups with independent walking and assisted walking, there were statistically significant differences in age, spinal motor symptoms, autonomic symptoms and CD4 cell percentage(P<0.01); and there were no significant differences in gender, infection, symptoms of optic nerve,sensory symptoms of spinal cord,CD3、CD8、CD19、CD4/CD8 and NK cell percentage(P>0.05); CD4 cell percentage was negatively correlated with physical disability(r=-0.480, P<0.01).Conclusion The higher of CD4 cell persentage,the lower incidence of physical disability. The CD4 cell percentage may helpful in immunologic mechanism of physical disability in NMOSD patients.%目的 探讨视神经脊髓炎谱系疾病(NMOSD)患者血CD4细胞百分比与肢体伤残的关系及其临床意义.方法 分析2015年1月-2016年6月上海市第一康复医院及仁济医院神经内科确诊的58例NMOSD患者临床与生化资料,根据扩展残疾状况评分量表(EDSS)将患者分为行走不受限组与受限组,并比较两组患者间的临床、生化特征;分析血CD4细胞百分比与肢体伤残的相关性.结果 行走不受限组与受限组之间患者在年龄、脊髓运动症状、自主神经症状及血CD4细胞百分比比较差异有统计学意义(P<0.01);性别、感染因素、视神经症状、脊髓感觉症状、CD3、CD8、CD19、CD4/CD8及NK细胞百分比比较差异无统计学意义(P>0.05);血CD4细胞百分比与肢体伤残呈负相关(r=-0.480,P<0.01).结论 NMOSD患者入院时血CD4细胞百分比越高,肢体残疾程度越低.血CD4细胞百分比有助于NMOSD患者肢体伤残发生免疫机制的探讨.