陆军军医大学第一附属医院眼科、视觉损伤与再生修复重庆市重点实验室,重庆 400038
Received:20 February 2022,
Published:28 August 2022
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王晓蕾,王贞,李小梅,等.中国西部地区脱髓鞘性视神经炎患者AQP4-IgG表达及其临床特征关系分析[J].重庆医科大学学报,2022,47(8):970-976.
Wang Xiaolei,Wang Zhen,Li Xiaomei,et al.Analysis of the relationship between AQP4-IgG expression and clinical characteristics in patients with demyelinated optic neuritis in western China[J].Journal of Chongqing Medical University,2022,47(8):970-976.
王晓蕾,王贞,李小梅,等.中国西部地区脱髓鞘性视神经炎患者AQP4-IgG表达及其临床特征关系分析[J].重庆医科大学学报,2022,47(8):970-976. DOI: 10.13406/j.cnki.cyxb.003084..
Wang Xiaolei,Wang Zhen,Li Xiaomei,et al.Analysis of the relationship between AQP4-IgG expression and clinical characteristics in patients with demyelinated optic neuritis in western China[J].Journal of Chongqing Medical University,2022,47(8):970-976. DOI: 10.13406/j.cnki.cyxb.003084..
目的
2
比较142例脱髓鞘性视神经炎(demyelinated optic neuritis,DON)患者血清或脑脊液中AQP4-IgG表达与其临床特征的关系。
方法
2
回顾性收集2016年1月至2020年10月于陆军军医大学第一附属医院眼科收治的142例DON患者AQP4-IgG检验结果,对AQP4-IgG阳性及阴性患者的临床资料进行分析。
结果
2
①检测到AQP4-IgG阳性者48例(33.8%),女性与男性比为5.9∶1,双眼同时发病者31例(64.6%),发病时LogMAR视力为0.48±0.64,随访结束时LogMAR视力为0.55±0.65。②检测到AQP4-IgG阴性者94例(66.2%),女性与男性比为1.7∶1,双眼同时发病者53例(56.4%),发病时LogMAR视力为0.54±0.61,随访结束时LogMAR视力为0.39±0.49。③AQP4-IgG阳性女性患者比例明显高于AQP4-IgG阴性患者(
χ
²=7.827,
P
<
0.01);二者双眼患病率不具有统计学差异(
χ
²=0.884,
P
>
0.05);
二者在发病时LogMAR视力并无统计学差异(
t
=-0.721,
P
>
0.05),但AQP4-IgG阳性患者视力预后更差(
t
=2.058,
P
<
0.05)。AQP4-IgG阳性患者血沉升高(
χ
²=5.403,
P
<
0.05),以及合并自身抗体结果阳性的比例比AQP4-IgG阴性患者更高(
χ
²=5.231,
P
<
0.05),二者均具有统计学差异。
结论
2
AQP4-IgG阳性的视神经脊髓炎谱系疾病患者女性发病率更高,视力预后更差,且可能合并自身抗体结果异常或者自身免疫性疾病。根据AQP4-IgG检测结果,准确地进行临床分型对治疗方案选择及预后分析具有重要指导意义。
Objective
2
To compare the relationship between AQP4-IgG expression and its clinical characteristics in the serum or cerebrospinal fluid of 142 patients with demyelinated optic neuritis(DON).
Methods
2
We retrospectively collected and analyzed the clinical data and AQP4-IgG results of 142 DON patients admitted to the Department of Ophthalmology of The First Affiliated Hospital of Army Medical University from January 2016 to October 2020.
Results
2
①AQP4-IgG positive was detected in 48 cases(33.8%),the female to male ratio was 5.9∶1,and 31 cases(64.6%) involved both eyes. The LogMAR visual acuity at the first visit was 0.48±0.64,and was 0.55±0.65 at the last visit. ②AQP4-IgG negative was detected in 94 cases(66.2%),the female to male ratio was 1.7∶1,and 53 cases(56.4%)involved both eyes. The LogMAR visual acuity at the first visit was 0.54±0.61,and was 0.39±0.49 at the last visit. ③The proportion of AQP4-IgG-positive female patients was significantly higher than that of AQP4-IgG-negative patients(
χ
²=7.827,
P
<
0.01); there was no statistical difference in the prevalence of both eyes(
χ
²=0.884,
P
>
0.05); there was no significant difference in LogMAR visual acuity at the time of onset(
t
=-0.721,
P
>
0.05),but AQP4-IgG positive patients had worse visual prognosis(
t
=2.058,
P
<
0.05).
AQP4-IgG positive patients had higher erythrocyte sedimentation rate(
χ
²=5.403,
P
<
0.05)and a higher proportion of combined autoantibody results than AQP4-IgG negative patients(
χ
²=5.231,
P
<
0.05),both of which had significant differences.
Conclusion
2
AQP4-IgG-positive patients with neuromyelitis optica spectrum disorders have a higher incidence of female morbidity,with worse visual prognosis,and may be combined with abnormal autoantibody results or autoimmune diseases. Accurate clinical classification based on AQP4-IgG detection is important for the treatment and prognosis.
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