摘要
目的探讨多发性硬化症(MS)患者外周血及脑脊液中滤泡辅助性T细胞(Tfh)、CXC趋化因子配体13(CXCL13)水平变化及其临床意义。方法前瞻性选取2014年6月至2017年6月四川省乐山市人民医院诊治的30例MS患者作为MS组,MS组给予甲泼尼龙治疗,同期选取30例其他非炎症性神经系统疾病(NINSD)患者作为NINSD组,所有患者均取外周血和脑脊液,采用流式细胞技术检测Tfh水平,采用酶联免疫吸附试验检测CXCL13水平,比较MS组和NINSD组外周血和脑脊液中Tfh和CXCL13水平,比较MS组治疗有效者(n=24)和治疗无效者(n=6)的Tfh和CXCL13水平,比较MS组治疗前后的外周血和脑脊液中的Tfh和CXCL13水平,分析Tfh与CXCL13水平的相关性。结果在外周血及脑脊液Tfh、CXCL13水平方面,MS组治疗前[(38.75±4.10)%、(18.04±2.08)%和(76.22±8.04)pg/ml、(21.65±2.32)pg/ml]明显高于NINSD组[(20.34±2.46)%、(8.24±1.41)%和(26.59±2.88)pg/ml、(3.34±0.58)pg/ml],MS组治疗后[(30.26±3.42)%、(14.87±1.63)%和(45.06±4.87)pg/ml、(3.34±0.58)pg/ml]明显低于治疗前,MS组治疗有效者治疗后[(24.32±2.89)%、(10.24±1.52)%和(36.25±3.82)pg/ml、(9.63±1.24)pg/ml]明显低于治疗无效者[(54.02±5.57)%、(33.39±3.67)%和(80.30±8.21)pg/ml、(29.88±3.28)pg/ml],差异具有统计学意义(P<0.05);Pearson相关性分析结果显示,Tfh水平与CXCL13水平呈正相关(P<0.05)。结论 Tfh、CXCL13水平的异常与MS的发病及病情转归有关,甲泼尼龙治疗可使MS患者的Tfh、CXCL13水平降低。
Objective To discuss the changes of follicular helper T cells（Tfh）,CXC chemokine ligand 13（CXCL13） levels in peripheral blood and cerebrospinal fluid of patients with multiple sclerosis（MS） and their clinical significance. Methods From June 2014 to June 2017,30 cases patients with MS were selected as MS group in People＇s Hospital of Leshan City,Sichuan Province,MS group was treated with methylprednisolone treatment,30 cases of other non inflammatory neurological diseases（NINSD） patients were selected as NINSD group. All patients were taken peripheral blood and cerebrospinal fluid,using flow cytometry to detect the level of Tfh. The level of CXCL13 was detected by enzyme linked immunosorbent assay. The levels of Tfh and CXCL13 in peripheral blood and cerebrospinal fluid of group MS and NINSD were compared. The levels of Tfh and CXCL13 in peripheral blood and cerebrospinal fluid before and after the treatment of MS group were compared,and those in the MS group were compared with those in the MS group. N = 24 and Tfh and CXCL13 levels in peripheral blood and cerebrospinal fluid in patients with ineffective treatment,and the correlation between Tfh and CXCL13 level was observed. Results In the cerebrospinal fluid and peripheral blood Tfh,CXCL13 levels,the MS group before treatment [（38. 75 ± 4. 10） %,（18. 04 ± 2. 08） % and（76. 22 ± 8. 04） pg/ml,（21. 65 ± 2. 32） pg/ml]were significantly higher than those of NINSD group [（20. 34 ± 2. 46） %,（8. 24 ± 1. 41） % and（26. 59 ± 2. 88） pg/ml,（3. 34 ± 0. 58） pg/ml],the MS group after treatment [（30. 26 ± 3. 42） %,（14. 87 ± 1. 63） % and（45. 06 ± 4. 87） pg/ml,（3. 34 ± 0. 58） pg/ml] were significantly lower than those of the before treatment,the effective treatment patients of MS group [（24. 32 ± 2. 89） %,（10. 24 ± 1. 52） % and（36. 25 ± 3. 82） pg/ml,（9. 63 ± 1. 24）pg/ml] were significantly lower than those of the invalid treatment patients [（54. 02 ± 5. 57） %,（33. 39 ± 3. 67）
作者
周薇
唐凌雯
熊毅
ZHOU Wei;TANG Ling-wen;XIONG Yi(Department of Neurology,People＇s Hospital of Leshan,Leshan Sichuan 614000,China.)
出处
《临床和实验医学杂志》
2018年第18期1977-1980,共4页
Journal of Clinical and Experimental Medicine
基金
四川省青年创新课题(编号:Q15070)
