目的 比較視神經(jīng)脊髓炎譜系疾?。∟MOSD）與多發(fā)性硬化（MS）急性發(fā)作期腦脊液膠質(zhì)纖維酸性蛋白（GFAP）水平差異，分析注射用丹參多酚酸對NMOSD的治療效果。方法 收集2016年8月——2017年12月就診于山西醫(yī)科大學第一醫(yī)院神經(jīng)內(nèi)科確診患者40例，包括NMOSD患者20例，MS患者20例。采用ELISA法檢測NMOSD和MS腦脊液GFAP水平。將NMOSD患者隨機分為觀察組和對照組，對照組采用糖皮質(zhì)激素與一般神經(jīng)營養(yǎng)藥物，包括甲基強的松龍和維生素B1、B6、B12，觀察組在此基礎上加用注射用丹參多酚酸0.13 g，每天1次，兩組均治療14 d。治療前后對患者進行日常生活能力（ADL）、擴展殘疾狀態(tài)量表（EDSS）評分。收集治療前后的血清進行GFAP水平檢測。結(jié)果 NMOSD組腦脊液GFAP水平顯著高于MS組（P<0.05）。觀察組和對照組用藥后ADL評分組間差異無統(tǒng)計學意義，但觀察組比對照組均數(shù)升高明顯，有上升趨勢；兩組用藥后EDSS評分組間差異無統(tǒng)計學意義，但觀察組均數(shù)降低明顯，有下降趨勢；治療后兩組患者血清GFAP水平較治療前均顯著下降（P<0.001），觀察組降低較對照組更顯著（P<0.001）。結(jié)論 星形膠質(zhì)細胞損傷引起的GFAP水平升高可以用于鑒別NMOSD與MS患者，注射用丹參多酚酸治療急性期NMOSD，患者神經(jīng)功能改善，血清GFAP水平可以間接反映NMOSD患者的病情進展。

Objective To compare the differences of cerebrospinal fluid levels of GFAP in acute attack between NMOSD and MS, and to analyze the effects of Salvianolic Acids for Injection on NMOSD. Methods Tatolly 40 patients diagnosed with neurology from the First Hospital of Shanxi Medical University were collected from August 2016 to December 2017, including 20 patients with NMOSD and 20 patients with MS. The levels of GFAP in cerebrospinal fluid of NMOSD and MS were detected by ELISA. NMOSD patients were randomly divided into treatment group and control group. The control group used glucocorticoid and general neurotrophic drugs, including methylprednisolone, vitamins B1, B6, and B12. The experimental group added salvianolic acid 0.13 g, both groups were treated for 14 days. The EDSS and ADL scores were collected before and after treatment. The serum levels of GFAP were collected before and after treatment. Results The level of GFAP in cerebrospinal fluid of NMOSD group was significantly higher than that of MS group (P<0.05); There was no significant difference in ADL scores between treatment group and control group. However, thetreatment group had a significantly higher mean than the control group, with an upward trend; There was no significant difference in the EDSS scores between treatment and control group, but the mean of the treatment group decreased significantly, with a downward trend; Serum GFAP levels decreased after treatment in both groups (P<0.001), the treatment group decreased more significantly (P<0.001). Conclusion GFAP induced by astrocyte damage can be used to identify patients with NMOSD and MS. After 14 days of treatment with Salvianolic Acids for Injection, the neurological function of patients improved. Serum GFAP levels can indirectly reflect the progression of NMOSD patients.

吳階平醫(yī)學基金會臨床項目（320.6750.16130）