本文選題：視神經(jīng)脊髓炎　切入點(diǎn)：多發(fā)性硬化　出處：《山西醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:纖維蛋白原(FIB)是重要的凝血蛋白,在血腦屏障破壞后沉積于中樞神經(jīng)系統(tǒng),引起適應(yīng)性免疫反應(yīng),誘導(dǎo)外周炎性細(xì)胞浸潤(rùn)并導(dǎo)致中樞神經(jīng)系統(tǒng)脫髓鞘。探討視神經(jīng)脊髓炎(NMO)發(fā)病急性期患者血漿FIB水平并分析其與疾病首發(fā)年齡、疾病病程、復(fù)發(fā)次數(shù)、疾病的嚴(yán)重程度及受累脊髓節(jié)段等臨床特點(diǎn)的相關(guān)性。方法:收集發(fā)病急性期NMO患者59例、復(fù)發(fā)緩解型多發(fā)性硬化(RRMS)患者56例、急性脊髓炎(AM)患者9例及19例良性發(fā)作性位置性眩暈(BPPV)患者為對(duì)照組的清晨空腹靜脈血,分別測(cè)定血漿纖維蛋白原(FIB)、凝血酶原時(shí)間(PT),活化部分凝血酶時(shí)間(APTT)、凝血酶時(shí)間(TT)水平,分析各指標(biāo)水平與患者臨床特點(diǎn)的相關(guān)性。結(jié)果:(1)NMO發(fā)病急性期,患者血漿FIB水平顯著高于對(duì)照組(P㩳0.0001);(2)NMO發(fā)病急性期,患者血漿FIB水平顯著高于RRMS組(P㩳0.0001),但與AM組相比無(wú)差異(P=0.444);(3)AM組血漿FIB水平與RRMS組相比差異具有統(tǒng)計(jì)學(xué)意義(P=0.001),與對(duì)照組相比(P=0.003);(4)RRMS組血漿FIB水平與對(duì)照組相比無(wú)顯著性差異;(5)NMO組、RRMS組及AM組血漿PT水平與對(duì)照組相比差異具有統(tǒng)計(jì)學(xué)意義(P=0.029,P=0.001,P=0.032),三組間比較無(wú)統(tǒng)計(jì)學(xué)差異;(6)NMO組與RRMS組相比血漿APTT水平具有顯著性差異(P=0.005),RRMS組血漿APTT水平高于AM組及對(duì)照組(P=0.007,P=0.018);(7)RRMS組血漿TT水平高于AM組及對(duì)照組(P=0.025,P=0.035);(8)采用EDSS評(píng)分量表評(píng)估疾病嚴(yán)重程度,NMO組急性期血漿FIB水平與EDSS分值顯著相關(guān)(P㩳0.0001,r=0.561),與患者發(fā)病年齡呈正相關(guān)(P=0.008,r=0.340);(9)RRMS組FIB水平與EDSS分值顯著相關(guān)(P=0.0024,r=0.302),與疾病病程正相關(guān)(P=0.013,r=0.329)。結(jié)論:NMO發(fā)病急性期血漿FIB水平升高并與疾病嚴(yán)重程度密切相關(guān),血漿FIB水平越高,提示患者病情越重。
[Abstract]:Objective: fibrinogen (FIB) is an important clotting protein in the blood brain barrier damage after deposition in the central nervous system, causing the adaptive immune response, induced by peripheral inflammatory cell infiltration and cause central nervous system demyelinating. Discussion of neuromyelitis optica (NMO) incidence of acute plasma levels of FIB and compare it with disease onset age, disease duration, recurrence times, correlation between the clinical features of the severity of the disease and the involved spinal cord segments etc.. Methods: collected 59 cases of acute stage NMO patients with relapsing remitting multiple sclerosis (RRMS) in 56 patients, acute myelitis (AM) in 9 cases and 19 cases of benign paroxysmal positional vertigo (BPPV) in patients with fasting venous blood as control group, respectively. The determination of plasma fibrinogen (FIB), prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) level, the level of indicators and analysis 鎮(zhèn)ｈ，

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