摘要
目的 探讨白细胞介素 (IL 6 )及其可溶性受体 (sIL 6R)在格林 巴利综合征 (GBS)发病中的作用及免疫抑制性药物对其影响。方法 按Asbury标准选择GBS患者 4 3例 ,并进行病情严重程度分级 (0～Ⅴ级 )。其中Ⅱ级 13例 ,Ⅲ级 2 3例 ,Ⅳ级 7例。按分层随机原则 ,将GBS者分为 2组 ,分别用肾上腺皮质类固醇 (激素 )和雷公藤多甙治疗 ,在开始前、治疗后第 8周各按统一标准进行评估 1次 ,并取静脉血和脑脊液 (CSF)配对标本 2mL ,用ELISA法测定sIL 6R和双抗体夹心ELISA法测定IL 6。结果 (1)病初GBS者血清IL 6、sIL 6R分别为 (6 9.73± 2 5.2 5)ng/L和 (4 6 .6 5± 11.59) μg/L ,明显高于对照组的 (17.94± 5.6 6 )ng/L和 (2 9.2 5± 11.0 4 )μg/L(t =13.16 ,7.33,P <0 .0 0 1) ,此外CSFIL 6、sIL 6R分别为 (14.33± 6 .6 9)ng/L和 (9.4 5± 0 .98) μg/L ,亦明显高于对照组的 (3.35± 2 .79)ng/L和 (1.38± 0 .50 ) μg/L(t=10 .0 2 ,4 8.4 8,P <0 .0 0 1)。(2 )病初GBS者CSFIL 6、sIL 6R与病情严重程度分级相关密切 (r=0 .6 7,0 .4 8,P <0 .0 1)。(3)雷公藤多甙与激素治疗后两组临床症状均有不同程度的改善。但雷公藤多甙组临床严重程度分级进步 1级以上者为 90 .3% ,明显高于激素组的6 1.9% (x2 =5.0 6 。
Objective To study the clinical effects of Trypergium polyglycoside (TII) in patients with Guillain Barre syndrome (GBS)and its possible mechanism. Methods Interleukin 6 (IL 6),soluble interleukin 6 receptor(sIL 6R) were measured in cerebrospinal fluid (CSF) and serum of 43 patients and 48 controls with GBS using ELISA and double antibodies sandwich ELISA method. Results The level of IL 6 in serum and CSF in GBS group [serum:(69.73±25.25) ng/L, CSF:(14.33±6.69) ng/L] was higher than in normal control group [serum: (17.94±5.66) ng/L, CSF:(3.35±2.79) ng/L]( t =13.16, 10.02; P <0.001), while the level of sIL 6R in serum and CSF of GBS group [serum:(46.65±11.59) μg/L, CSF:(9.45±0.98) μg/L] was also higher than in normal control group [serum: (29.25±11.04) μg/L, CSF:(1.38±0.50) μg/L] ( t =7.33,48.48, P <0.001). There were positive correlation between CSF IL 6, sIL 6R and clinical severity ( r =0.67, 0.48, P <0.01). After treatment with TII and corticosteroid the disease showed improved,as the level of CSF IL 6 and sIL 6R came down simultaneously. Moreover, a significant difference in CSF IL 6, sIL 6R of TII group and corticosteroid group ( t =2.49, 2.26, P <0.05) was observed . Conclusion The level of CSF IL 6 and sIL 6R were a good index of severity and the TII was a useful drug in the treatment of GBS.
出处
《中国神经免疫学和神经病学杂志》
CAS
2000年第2期73-77,共5页
Chinese Journal of Neuroimmunology and Neurology
基金
浙江省卫生厅科研基金!资助项目 (SQ940 0 1)
关键词
格林-巴利综合征
雷分藤多甙
IL-6
SIL-6R
Guillain Barre syndrome
Tryperygium
polyglycoside
interleukin 6
soluble interleukin 6 receptor
