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目的探讨多发性硬化(MS)的早期表现——临床孤立综合征(CIS)患者血清及脑脊液中血管内皮生长因子(VEGF)水平及其临床意义。方法 25例CIS患者及21例对照组,CIS患者发作期行扩展残疾状态量表(EDSS)评分、寡克隆带测定及MRI检查,液相芯片分析技术检测血清及脑脊液VEGF浓度。结果 CIS患者发作期脑脊液VEGF平均荧光强度比对照组高,差异有统计学意义(P=0.01);脊髓病灶长度≥3个脊柱节段的CIS患者脑脊液VEGF水平比脊髓病灶长度<3个脊柱节段的患者高,差异有统计学意义(P=0.036)。CIS患者血清及脑脊液VEGF水平与EDSS评分、血脑屏障指数(BBB)及MRI病灶强化无明显相关性(P>0.05)。结论 CIS患者发作期脑脊液VEGF水平高于对照组,可能与MS发病及脊髓纵向扩散病灶的形成有关。血清及脑脊液VEGF水平与神经功能残疾、BBB破坏的关系尚有待证实。
Objective To investigate the early manifestation of multiple sclerosis (MS) - the level of vascular endothelial growth factor (VEGF) in serum and cerebrospinal fluid of patients with clinical isolated syndrome (CIS) and its clinical significance. Methods Twenty-five patients with CIS and 21 controls were enrolled in this study. Patients with CIS were assessed for EDSS, oligoclonal bands and MRI, and serum VEGF levels were measured by liquid chromatography. Results The mean fluorescence intensity of VEGF in cerebrospinal fluid in patients with CIS was significantly higher than that in control group (P = 0.01). The levels of VEGF in cerebrospinal fluid of CIS patients with spinal lesions ≥3 spine segments were less than 3 spinal segments The segment of patients with high, the difference was statistically significant (P = 0.036). Serum and cerebrospinal fluid VEGF levels in patients with CIS had no significant correlation with EDSS score, BBB score and MRI enhancement (P> 0.05). Conclusion The level of VEGF in cerebrospinal fluid of patients with CIS is higher than that of control group in the episode of CIS, which may be related to the onset of MS and the formation of longitudinal diffusion lesions in the spinal cord. Serum and cerebrospinal fluid VEGF levels and neurological dysfunction, BBB destruction remains to be confirmed.