山东大学学报(医学版) ›› 2016, Vol. 54 ›› Issue (10): 50-54.doi: 10.6040/j.issn.1671-7554.0.2015.1350
孙昊,汪春娟,王戈,王宝洁,郭守刚
SUN Hao, WANG Chunjuan, WANG Ge, WANG Baojie, GUO Shougang
摘要: 目的 探讨伴有及不伴常见非器官特异性自身抗体的视神经脊髓炎谱系疾病(NMOSD)患者的临床特点。 方法 收集36例NMOSD患者,其中伴有常见非器官特异性自身抗体者26例(阳性组),不伴常见非器官特异性自身抗体者10例(阴性组),比较两组临床表现、实验室检查及影像学特点。 结果 36例NMOSD患者中伴有至少一种常见非器官特异性自身抗体者占72.22%,并以抗核抗体、抗SSA抗体、抗Ro-52抗体为主。阳性组患者发病年龄晚于阴性组,且更易合并非器官特异性自身免疫疾病及肿瘤;阴性组患者首发症状中,视神经炎/脊髓炎比例明显高于阳性组,而阳性组的脑脊液压力及蛋白含量均明显高于阴性组;两组间其他临床、实验室及病灶分布特点相似。 结论 伴有常见非器官特异性自身抗体的NMOSD患者中枢神经系统炎症反应更严重,更易合并非器官特异性自身免疫疾病及肿瘤。
中图分类号:
[1] Wingerchuk DM, Lennon VA, Lucchinetti CF, et al. The spectrum of neuromyelitis optica[J]. Lancet Neurol, 2007, 6(9):805-815. [2] Zhang B, Zhong Y, Wang Y, et al. Neuromyelitis optica spectrum disorders without and with autoimmune diseases [J]. BMC Neurol, 2014, 14:162. doi:10.1186/s12883-014-0162-7. [3] Pittock SJ, Lennon VA, de Seze J, et al. Neuromyelitis optica and non-organ-specific autoimmunity [J]. Arch Neurol, 2008, 65(1):78-83. [4] Freitas E, Guimaraes J. Neuromyelitis optica spectrum disorders associated with other autoimmune diseases [J]. Rheumatol Int, 2015, 35(2):243-253. [5] Wingerchuk DM, Weinshenker BG. The emerging relationship between neuromyelitis optica and systemic rheumatologic autoimmune disease [J]. Mult Scler, 2012, 18(1):5-10. [6] Wingerchuk DM, Banwell B, Bennett JL, et al. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders [J]. Neurology, 2015, 85(2):177-189. [7] 武雷, 黄德晖, 杨扬, 等. 血清抗核抗体在视神经脊髓炎谱系疾病和多发性硬化中的分布[J]. 中国神经免疫学和神经病学杂志, 2011, 18(4):243-245. WU Lei, HUANG Dehui, YANG Yang, et al. Distribution of antinuclear antibodies in patients with neuromyelitis optica spectrum disorders and multiple sclerosis[J]. Chinese Journal of Neuroimmunology and Neurology, 2011, 18(4):243-245. [8] Kim W, Kim SH, Lee SH, et al. Brain abnormalities as an initial manifestation of neuromyelitis optica spectrum disorder[J]. Mult Scler, 2011, 17(9):1107-1112. [9] Iyer A, Elsone L, Appleton R, et al. A review of the current literature and a guide to the early diagnosis of autoimmune disorders associated with neuromyelitis optica [J]. Autoimmunity, 2014, 47(3):154-161. [10] Bienia B, Balabanov R. Immunotherapy of neuromyelitis optica[J]. Autoimmune Dis, 2013, 2013:741490. doi:10.1155/2013/741490. Epub 2013 Dec 25. [11] Cai G, He D, Chu L, et al. Paraneoplastic neuromyelitis optica spectrum disorders:three new cases and a review of the literature[J]. Int J Neurosci, 2016, 126(7):660-668. [12] Iorio R, Rindi G, Erra C, et al. Neuromyelitis optica spectrum disorder as a paraneoplastic manifestation of lung adenocarcinoma expressing aquaporin-4[J]. Mult Scler, 2015, 21(6):791-794. [13] Figueroa M, Guo Y, Tselis A, et al. Paraneoplastic neuromyelitis optica spectrum disorder associated with metastatic carcinoid expressing aquaporin-4[J]. JAMA Neurol, 2014, 71(4):495-498. [14] Park JH, Hwang J, Min JH, et al. Presence of anti-Ro/SSA antibody may be associated with anti-aquaporin-4 antibody positivity in neuromyelitis optica spectrum disorder[J]. J Neurol Sci, 2015, 348(1-2):132-135. [15] 贾红娟, 叶静, 赵义, 等. 抗核抗体谱阳性的视神经脊髓炎患者的临床和磁共振特征分析[J]. 中华医学杂志, 2012, 92(43):3042-3045. JIA Hongjuan, YE Jing, ZHAO Yi, et al. Clinical and magnetic resonance imaging features of neuromyelitis optics with positive anti-nuclear antibody serum[J]. National Medical Journal of China, 2012, 92(43):3042-3045. [16] Pu S, Long Y, Yang N, et al. Syndrome of inappropriate antidiuretic hormone secretion in patients with aquaporin-4 antibody[J]. J Neurol, 2015, 262(1):101-107. [17] Gao C, Wu L, Chen X, et al. Hypothalamic abnormality in patients with inflammatory demyelinating disorders[J]. Int J Neurosci, 2016, 5:1-8. doi:10.3109/00207454.2015.1114484. |
[1] | 王震,高计芳,关新媛,郭娟娟,杨笃晓,刘师莲. PC12细胞中Vd介导的SPHK1/S1P通路及其在EAE中的潜在功能[J]. 山东大学学报(医学版), 2016, 54(10): 21-24. |
[2] | 刘光云, 丛琳, 郭守刚. 多发性硬化患者认知功能障碍的特点[J]. 山东大学学报(医学版), 2015, 53(10): 51-54. |
[3] | 戴庭敏, 沈遥遥, 涂江龙, 丁剑午. 氟尿嘧啶诱导急性可逆性脑白质病1例[J]. 山东大学学报(医学版), 2015, 53(4): 95-96. |
[4] | 李晓红1,2,李芸1,王班琴1,刘师莲1. 山东汉族人群DBP基因多态性与多发性硬化的相关性[J]. 山东大学学报(医学版), 2010, 48(4): 67-. |
[5] | 由玮,毕建忠,谢兆宏,朱正禹,王晓云. 酶酚酸酯对实验性自身免疫性脑脊髓炎大鼠神经功能的影响[J]. 山东大学学报(医学版), 2008, 46(6): 574-578. |
|