视神经脊髓炎谱系疾病患者中水通道蛋白4抗体与视神经损害的相关性

摘要

目的 探讨视神经脊髓炎谱系疾病(NMOSD)患者中水通道蛋白4(AQP4)抗体与视神经损害的关系及其临床意义.方法 回顾性分析2010年1月至2015年10月我院经AQP4抗体检测确诊的53例NMOSD患者的临床与生化资料.根据是否有视神经损害分为视神经损害组与无视神经损害组,比较2组患者的临床与生化特征.根据AQP4抗体是否阳性将患者分为AQP4抗体阳性组与阴性组,比较2组视神经损害发生率.分析AQP4抗体与视神经损害的相关性.结果 视神经损害组与无视神经损害组比较,患者性别、发病年龄、病程、括约肌功能障碍发生率、外周血白细胞计数、谷丙转氨酶值、脑脊液蛋白值、脑脊液免疫球蛋白指数及寡克隆带阳性率的差异无统计学意义(P＞0.05),复发次数、浅感觉减退发生率、血肌酐值及AQP4抗体阳性率的差异有统计学意义(P＜0.05).AQP4抗体阳性组与AQP4抗体阴性组比较,视神经损害发生率的差异有统计学意义(F=4.93,P＜ 0.05).AQP4抗体与视神经损害发生呈正相关(r=0.297,P＜0.05).结论 NMOSD患者AQP4抗体阳性易出现视神经损害,两者的正相关关系有助于NMOSD患者视神经损害的早期预判及病情监测.%Objective To determine the correlation between aquaporin-4 antibody (AQP4-Ab) and optic neuropathy in patients with neuromyelitis optica spectrum disorder (NMOSD).Methods The clinical and biochemical data of 53 patients with NMOSD diagnosis based on AQP4-Ab level in Changhai Hospital between January 2010 and October 2015 were retrospectively analyzed.According to optic neuropathy occurrence,the NMOSD patients were divided into optic neuropathy and non-optic neuropathy groups.Clinical and biochemical characteristics were compared between the two groups.According to the serum AQP4-Ab levels,the NMOSD patients were divided into AQP4-Ab seropositive and seronegative groups.The incidence of optic neuropathy was compared between the two groups.The correlation between optic neuropathy and AQP4-Ab levels was analyzed.Results Between the optic neuropathy and non-optic neuropathy groups,no significant differences in sex,age at onset,disease course,serum alanine aminotransferase levels,protein levels in cerebral spinal fluid,IgG index,and oligoclonal band were observed (P ＞ 0.05).However,statistically significant differences were found in frequency,superficial sensory impairment,serum creatinine level,and serum AQP4-Ab level (P ＜ 0.05).Between the AQP4-Ab sempositive and semnegative groups,a statistically significant difference in the incidence of optic neuropathy was observed (F =4.93,P ＜ 0.05).The incidence of optic neuropathy positively correlated with AQP4-Ab levels (r =0.297,P ＜ 0.05).Conclusion NMOSD patients with AQP4-Ab seropositivity could be prone to optic neuropathy,and the correlation may be beneficial to early diagnosis,therapy,and monitoring of NMOSD.