论文部分内容阅读
目的研究多发性硬化（ＭＳ）免疫异常过程中肿瘤坏死因子（ＴＮＦ－α）和循环细胞间粘附分子－１（ｃＩＣＡＭ－１）的变化及与血脑屏障（ＢＢＢ）的相关性。方法用酶联免疫吸附试验（ＥＬＩＳＡ）及单项琼脂扩散（ＳＩＲＤ）检测临床确诊为ＭＳ的３１例病人血清及脑脊液（ＣＳＦ）中ＴＮＦ－α、ｃＩＣＡＭ－１及白蛋白（Ａｌｂ）比值。结果①３１例ＭＳ患者中Ａｌｂ比值轻度异常８例（２５％），正常者２３例；ＩｇＧ指数增高（＞０．７）者２１例（６８％）。②ＭＳ组ＣＳＦ及血清中可检出高水平ＴＮＦ－α，较对照组显著增高（Ｐ＜０．０１，Ｐ＜０．０５）；ＣＳＦ中ｃＩＣＡＭ－１水平较对照组增高明显，差异有显著性（Ｐ＜０．０１）。③活动性ＭＳ患者ＣＳＦ中ＴＮＦ－α水平较静止期增高，差异有显著性（Ｐ＜０．０１）。两组ｃＩＣＡＭ－１水平也有显著差异（Ｐ＜０．０５）。④ＢＢＢ轻微损害 ＭＳ的 ＣＳＦ中 ｃＩＣＡＭ－１水平较 ＢＢＢ正常组增高，且与 ＣＳＦ中 ＴＮＦ－α水平呈正相关（ｒ＝０．４７８）。结论ＣＳＦ及血清中高水平ＴＮＦ－α与ｃＩＣＡＭ－１可能在ＭＳ病人鞘内炎症病理机制中起重要作用，ｃＩＣＡＭ－１可能成为ＭＳ活动的标志。一部分ＭＳ有一定程度ＢＢＢ损害且?
Objective To investigate the changes of tumor necrosis factor-α (TNF-α) and circulating intercellular adhesion molecule-1 (cICAM-1) and their relationship with the blood-brain barrier (BBB) in patients with multiple sclerosis (MS) Methods Serum and cerebrospinal fluid (CSF) TNF-α, cICAM-1 and albumin (Alb) were detected by enzyme linked immunosorbent assay (ELISA) and single agar diffusion (SIRD) in 31 patients with clinically diagnosed MS. Results ① Among the 31 patients with MS, mild Alb abnormality was found in 8 (25%) and normal (23) patients. 21 (68%) patients had elevated IgG index (> 0.7). (2) The level of TNF-α in CSF and serum of MS group was significantly higher than that in control group (P <0.01, P <0.05); the level of cICAM-1 in CSF was significantly higher than that in control group (P <0.01). (3) The level of TNF-α in active MS patients was higher than that in quiescent phase, the difference was significant (P <0.01). There was also a significant difference in cICAM-1 levels between the two groups (P <0.05). ④ The level of cICAM-1 in cerebrospinal fluid of MS patients with mild BBB was higher than that of normal BBB group, and positively correlated with the level of TNF-α in CSF (r = 0.478). Conclusion High levels of TNF-α and cICAM-1 in CSF and serum may play an important role in the pathogenesis of intrathecal inflammation in MS patients. CICAM-1 may be a marker of MS activity. Some MS has some BBB damage and?