[1]姜 曌,徐 典,李 力△.视神经脊髓炎谱系疾病复发与外周血免疫细胞水平相关性分析[J].陕西医学杂志,2020,49(6):736-740758.[doi:DOI:10.3969/j.issn.10007377.2020.06.024]
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视神经脊髓炎谱系疾病复发与外周血免疫细胞水平相关性分析
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年6期
页码:
736-740758
栏目:
临床研究
出版日期:
2020-06-05

文章信息/Info

作者:
姜 曌1徐 典2李 力1△
1.空军军医大学西京医院神经内科(西安710032); 2.空军军医大学口腔医院综合科(西安710032)
关键词:
视神经脊髓炎谱系疾病 利妥昔单抗 外周血淋巴细胞 磁共振成像 水通道蛋白4 视觉诱发电位
分类号:
R744
DOI:
DOI:10.3969/j.issn.10007377.2020.06.024
文献标志码:
A
摘要:
目的:分析视神经脊髓炎谱系疾病(NMOSD)患者发病时相关实验室检查及免疫细胞的监测数据,以期确定适合中国人群的NMOSD复发指标。方法:通过医院电子病例系统回顾性收集NMOSD复发患者临床资料,完善各项影像学检查及实验室检查,采用间接免疫荧光法检查血清及脑脊液水通道蛋白-4抗体等生化指标; 完善单核细胞比例、CD19+B细胞比例、CD19+/CD27+B细胞比值进行检测。在常规对症治疗的基础上给予甲强龙、免疫球蛋白等免疫治疗和利妥昔单抗治疗,并对部分患者进行随访。 结果:共收集到NMOSD患者18例。患者复发时CD19+B细胞比例的95%可信区间下限值为0.0060,CD19+/CD27+B细胞比例的95%可信区间下限值为0.0115。经过治疗,有15例患者临床症状明显改善(15/18,83.3%),随访3个月后,5例患者外周血中相关淋巴细胞比例明显下降并无异常升高。结论:当NMOSD患者外周血中CD19+/CD27+B细胞比例超过0.0115时,应采取免疫靶向药物对相应淋巴细胞进行清除治疗,以防止复发。

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更新日期/Last Update: 2020-07-28