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目的探讨糖皮质激素对复发缓解型多发性硬化(RRMS)患者血清及脑脊液白介素-23(IL-23)、白介素-17(IL-17)、血清tau蛋白、S100蛋白的影响。方法选取于神经内科入院治疗的RRMS患者50例作为RRMS组,采取糖皮质激素治疗;选取同期神经系统非炎症疾病(NNID)患者50例作对照组。采用双抗体夹心酶联免疫吸附(ELISA)法检测RRMS组治疗前后和对照组血清及脑脊液白介素、血清tau蛋白、S100蛋白的变化情况。结果 RRMS组治疗前与对照组相比,tau蛋白、S100蛋白差异无统计学意义,与治疗后相比差异亦无统计学意义(P>0.05)。RRMS组治疗前后血清及脑脊液中IL-23、IL-17水平均高于对照组,差异有统计学意义(P<0.05)。治疗后RRMS组血清IL-23、IL-17水平分别为(391.25±82.25)pg/ml、(49.52±12.25)pg/ml,脑脊液IL-23、IL-17水平分别为(308.63±38.51)pg/ml、(50.28±10.69)pg/ml,显著低于治疗前,差异均有统计学意义(P<0.05)。治疗后RRMS组ADL评分为(69.84±7.63)分,显著高于治疗前;EDSS评分为(2.67±0.84)分,显著低于治疗前,差异均有统计学意义(P<0.05)。结论 RRMS发病期与血清及脑脊液IL-23、IL-17表达水平有关,与血清tau蛋白、S100蛋白无关,糖皮质激素可降低血清及脑脊液IL-23、IL-17水平。
Objective To investigate the effects of glucocorticoids on serum and cerebrospinal fluid interleukin-23 (IL-23), interleukin-17 (IL-17), serum tau protein and S100 protein in patients with relapsing remitting multiple sclerosis (RRMS) Methods Fifty patients with RRMS admitted to Department of Neurology were enrolled as RRMS group and treated with glucocorticoid. Fifty consecutive patients with NNID were selected as control group. Serum and cerebrospinal fluid levels of interleukin, serum tau and S100 protein in RRMS group before and after treatment were measured by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). Results Compared with the control group, there was no significant difference of tau protein and S100 protein in RRMS group before treatment (P> 0.05). The levels of IL-23 and IL-17 in serum and cerebrospinal fluid in RRMS group were significantly higher than those in control group before and after treatment (P <0.05). Serum levels of IL-23 and IL-17 in RRMS group were (391.25 ± 82.25) pg / ml and (49.52 ± 12.25) pg / ml respectively after treatment and the levels of IL-23 and IL-17 in cerebrospinal fluid were (308.63 ± 38.51) pg (50.28 ± 10.69) pg / ml, significantly lower than before treatment, the difference was statistically significant (P <0.05). After treatment, the ADL score of RRMS group was (69.84 ± 7.63) points, which was significantly higher than that before treatment; the EDSS score was (2.67 ± 0.84) points, which was significantly lower than that before treatment (P <0.05). Conclusion The incidence of RRMS is related to the levels of IL-23 and IL-17 in serum and cerebrospinal fluid, but not with serum tau protein and S100 protein. Glucocorticoid can reduce the levels of IL-23 and IL-17 in serum and cerebrospinal fluid.