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目的探讨神经精神狼疮(N PLE)患者脑脊液(CSF)中层粘蛋白(LN)、透明质酸(H A)含量变化及临床意义。方法采用放射免疫法测定了系统性红斑狼疮(SLE)患者67例(其中N PLE31例,非NPLE36例)CSF中LN、H A水平;同时检测非SLE所致的脑血管病23例、正常对照组39例脑脊液中LA、H A含量。结果N PLE组CSF中LN、H A明显高于正常对照组、非NPLE-SLE组和非SLE所致的脑血管病组(P<0.01)。治疗有效的N PLE患者CSF中LN、H A较治疗前明显下降(P<0.05)。N PLE患者血清LN、H A与CSF中的LN、H A经直线相关分析,二者呈正相关(P<0.05)。CSF中LN、H A与CSF压力、蛋白、细胞数呈正相关(P<0.05)。结论SLE患者CSF中LN、H A的测定对临床诊断及预测N PLE提供了帮助。G SF中LN、H A含量的改变在一定程度上反映了SLE患者神经系统损害的程度,其动态监测可作为N PLE疗效和预后判断的参考指标。
Objective To investigate the changes and clinical significance of laminin (LN) and hyaluronic acid (H A) in cerebrospinal fluid (CSF) of patients with neuropsychiatric lupus. Methods The levels of LN and HA in 67 patients with systemic lupus erythematosus (SLE) were detected by radioimmunoassay in 31 cases of NLE and 36 cases of non-NPLE. Cerebral vascular diseases caused by non-SLE were detected in 23 cases and normal controls 39 cases of cerebrospinal fluid LA, HA content. Results The LN and H A levels in CSF of N PLE group were significantly higher than those of normal control group, non-NPLE-SLE group and non-SLE group (P <0.01). The effective LN patients with N PLE CSF LN, H A significantly decreased compared with before treatment (P <0.05). LN, H A in serum of patients with N PLE and LN and H A in CSF were linearly correlated (P <0.05). CSF, LN, H A and CSF pressure, protein, cell number was positively correlated (P <0.05). Conclusion The determination of LN and H A in the CSF of SLE patients may be of help in the clinical diagnosis and prediction of N PLE. The change of LN and H A in G SF partly reflects the degree of nervous system damage in patients with SLE. The dynamic monitoring can be used as a reference index for curative effect and prognosis of N PLE.