分泌型磷脂酶A2、溶血磷脂酸与多发性硬化相关性研究及临床意义(新)

·论著·分泌型磷脂酶A2、溶血磷脂酸与多发性

硬化相关性研究及临床意义

蒋东晓连艳芬

【摘要】目的观察多发性硬化（MS）患者血及脑脊液中分泌型磷脂酶A2（sPLA2）和溶血磷

脂酸（LPA）水平的变化及相关性。方法选取21例急性期MS患者（急性期MS组），20例缓解期

MS患者（缓解期MS组），21例非炎性、血管性神经系统疾病患者（对照组），测定三组血sPLA2、血

浆LPA及脑脊液sPLA2、LPA水平，并进行比较。结果急性期MS组血及脑脊液sPLA2、LPA水

平均显著高于缓解期MS组和对照组（P＜0.01）。急性期MS组经治疗后血及脑脊液sPLA2、LPA

水平显著低于治疗前（P＜0.01）。急性期MS组治疗前后血sPLA2与LPA水平存在相关性（r＝

0.962，P＝0.000；r＝0.848，P＝0.000）；急性期MS组治疗前后脑脊液sPLA2与LPA水平存在相关

性（r＝0.968，P＝0.000；r＝0.850，P＝0.000）。结论血及脑脊液sPLA2、LPA水平可作为评估MS

患者疾病活动性的炎性标志物。

【关键词】多发性硬化；分泌型磷脂酶A2；溶血磷脂酸

The relationship and clinical significance of secretory phospholipase A2and lysophosphatidic

acid in multiple sclerosis Jiang Dongxiao,Lian Yanfen.Department of Neruology,Weihai Wendong

Central Hospital Affiliated of Weifang Medical College,Shandong Weihai264400,China

Corresponding author:Jiang Dongxiao,Email:jdx_jiang@

[Abstract]Objective To explore the levels of secretory phospholipase A2(sPLA2)and lysophosphatidic acid(LPA)in blood and cerebrospinal fluid of patients with multiple sclerosis(MS),and

to explore the relationship between the levels of these inflammatory biomarkers and disease activity of

MS.Methods Blood samples were collected from21MS patients of acute period(acute period of MS

group),20MS patients of remitting period(remitting period of MS group)and21patients with non inflammatory and vascular neurologic disease(control group).The levels of sPLA2and LPA in blood and cerebrospinal fluid were measured and compared.Results The levels of sPLA2and LPA in blood and cerebrospinal fluid before treatment in acute period of MS group were significantly higher than those in

remitting period of MS group(P＜0.01)and in control group(P＜0.01).The levels of sPLA2and LPA in

blood and cerebrospinal fluid after treatment were significantly lower than those before treatment in acute

period of MS group(P＜0.01).The levels of sPLA2and LPA in blood before and after treatment had correlations in acute period of MS group(r＝0.962,P＝0.000；r＝0.848,P＝0.000).The levels of sPLA2

and LPA in cerebrospinal fluid before and after treatment had correlations in the acute period group(r＝

0.968,P＝0.000；r＝0.850,P＝0.000).Conclusions The levels of sPLA2and LPA in blood and cerebrospinal fluid may be used as inflammatory biomarkers for disease activity in MS patients.

[Key words]Multiple sclerosis;Secretory phospholipase A2;Lysophosphatidic acid

多发性硬化（MS）是一种慢性中枢神经系统炎性脱髓鞘疾病，临床以多发病灶及病程反复为特点，其病理表现主要是淋巴细胞和巨噬细胞对髓鞘

的破坏及继发性轴索损害[1]。分泌型磷脂酶A2（sPLA2）为钙依赖的磷脂酶家族成员之一，由血管平滑肌细胞与巨噬细胞等产生，它能够水解细胞膜磷脂的第2位酰基，产生溶血磷脂酸（LPA）、游离脂肪酸及多种炎性因子，如白细胞介素、血小板激活因子前体等[2-3]。LPA是调节细胞生存与凋亡的重要信号分子，与肿瘤、动脉粥样硬化及缺血性心脑

DOI：10.3760/cma.j.jssn.1673-4904.2016.11.001

作者单位：264400潍坊医学院附属威海市文登中心医院神经内科

通信作者：蒋东晓，Email：jdx_jiang@