血清补体C3、C4水平与视神经炎的相关性分析
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摘要
目的:探讨外周血血清补体C3、C4水平与视神经炎的相关性。方法:病例对照研究设计。收集2018-01/08在复旦大学附属眼耳鼻喉科医院确诊为视神经炎的患者137例作为研究组,同时收集体检中心健康者147例作为对照组。采用罗氏全自动生化分析仪测定两组血清补体C3、C4水平。对两组外周血血清补体C3、C4水平进行单因素、多因素Logistic回归分析,并采用受试者工作特性(ROC)曲线探讨外周血补体C3、C4水平对视神经炎的诊断价值。结果:研究组血清补体C3水平(96.17±17.93mg/dL)、C4水平(22.41±7.53mg/dL)均显著低于对照组水平(108.85±15.94、24.55±6.37mg/dL)(P<0.05)。多因素Logistic回归分析发现:补体C3水平下降(OR=1.048,P<0.001,95%CI:1.031～1.065),补体C4水平下降(OR=1.045,P=0.014,95%CI:1.009～1.083)为视神经炎发病的危险因素。结论:视神经炎患者外周血血清补体C3和C4水平相比对照组均显著降低,外周血补体C3和C4水平下降可能为视神经炎发病的独立危险因素。
?AIM: To explore the association between serum complement C3 and C4 with optic neuritis.?METHODS: Case-control study design. Optic neuritis subjects(n=137) and control subjects(n=147) who attended the Eye-ENT Hospital of Fudan University from January to August 2018 were recruited. The levels of serum complement C3 and C4 was detected by Roche automatic biochemical analyzer. Univariate analysis and multivariate Logistic regression analysis were performed to compare the level of serum complement C3 and C4 between optic neuritis group and control group. ROC analysis was performed to analysis the diagnosis value of C3 and C4 to distinguish optic neuritis patients.?RESULTS: The levels of serum complement C3 and C4 was significant lower(P<0.05) in optic neuritis group(96.17±17.93 mg/dL),(22.41±7.53 mg/dL) compared with control group(108.85±15.94 mg/dL),(24.55±6.37 mg/dL). Multivariate logistic regression analysis shown that decreased level of complement C3(OR=1.048, P<0.001, 95%CI:1.031-1.065) and C4(OR=1.045, P=0.014, 95%CI: 1.009-1.083) was a risk factor for optic neuritis.?CONCLUSION: The levels of serum complement C3 and C4 was decreased which suggested that the decreased level of complement C3 and C4 was risk factor for optic neuritis.
?AIM: To explore the association between serum complement C3 and C4 with optic neuritis.?METHODS: Case-control study design. Optic neuritis subjects(n=137) and control subjects(n=147) who attended the Eye-ENT Hospital of Fudan University from January to August 2018 were recruited. The levels of serum complement C3 and C4 was detected by Roche automatic biochemical analyzer. Univariate analysis and multivariate Logistic regression analysis were performed to compare the level of serum complement C3 and C4 between optic neuritis group and control group. ROC analysis was performed to analysis the diagnosis value of C3 and C4 to distinguish optic neuritis patients.?RESULTS: The levels of serum complement C3 and C4 was significant lower(P<0.05) in optic neuritis group(96.17±17.93 mg/dL),(22.41±7.53 mg/dL) compared with control group(108.85±15.94 mg/dL),(24.55±6.37 mg/dL). Multivariate logistic regression analysis shown that decreased level of complement C3(OR=1.048, P<0.001, 95%CI:1.031-1.065) and C4(OR=1.045, P=0.014, 95%CI: 1.009-1.083) was a risk factor for optic neuritis.?CONCLUSION: The levels of serum complement C3 and C4 was decreased which suggested that the decreased level of complement C3 and C4 was risk factor for optic neuritis.
引文
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7中华医学会眼科学分会神经眼科学组.视神经炎诊断和治疗专家共识(2014).中华眼科杂志2014;50(6):459-462
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11李鑫鑫,徐元勇.补体C3促进HIV-1感染的作用.生物技术通讯2015;26(1):124-126
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14 Sun L,Weng H,Li Z.Elevation of AQP4 and selective cytokines in experimental autoimmune encephalitis mice provides some potential biomarkers in optic neuritis and demyelinating diseases.Int J Clin Exp Pathol 2015;8(12):15749-15758
15 Li SJ,Chen YH,Shao MX,et al.Association of Plasma Complement C3 Levels With Primary Angle-Closure Glaucoma in Older Women.Invest Ophthalmol Vis Sci 2017;58:682-689
16 Sabater L,Giralt A,Boronat A,et al.Cytotoxic effect of neuromyelitis optica antibody (NMO-IgG) to strocytes:An in vitro study.J Neuroimmunol 2009;215(1-2):31-35
17 Wallis R,Mitchell DA,Schmid R,et al.Paths reunited:Initiation ofthe classical and lectin pathways of complement activation.Immunobiology 2010;215(1):1-11
18 Ram S,Lewis LA,Rice PA.Infections of people with complement deficiencies and patients who have undergone splenectomy.Clin Microbiol Rev 2010;23:740-780
2 Loncarek K,Brajac I,Petricek I,et al.Epidemiology of monosymptomatic optic neuritis in Rijeka County,Croatia:meteorological aspects.Coll Antropol 2005;29(1):309-313
3 Taylor BV,Lucas RM,Dear K,et al.Latitudinal variation in incidence and type of first central nervous system demyelinating events.Mult Scler 2010;16(4):398-405
4 Morrow MJ,Wingerchuk D.Neuromyelitis optica.J Neuroophthalmol 2012;32(2):154-166
5 Lucas RM,Ponsonby AL,Dear K,et al.Current and past Epstein-Barr virus infection in risk of initial CNS demyelination.Neurology 2011;77(4):371-379
6 Skattum L,Van deuren M,Vander P,et al.Complement deficiency states and associated infections.Mol Immunol 2011;48(14):1643-1655
7中华医学会眼科学分会神经眼科学组.视神经炎诊断和治疗专家共识(2014).中华眼科杂志2014;50(6):459-462
8 Singh M,Khan RS,Dine K,et al.Intracranial Inoculation Is More Potent Than Intranasal Inoculation for Inducing Optic Neuritis in the Mouse Hepatitis Virus-Induced Model of Multiple Sclerosis.Front Cell Infect Microbiol 2018;4(8):311
9 Curras-Martin D,Campbell N,Haroon A,et al.Recurrent optic neuritis as the only manifestation of chronic hepatitis B virus flare:a case report.J Med Case Rep 2018;12(1):316
10李圣杰,张爱平,曹文俊.补体缺陷及其疾病.检验医学2015;30(2):195-199
11李鑫鑫,徐元勇.补体C3促进HIV-1感染的作用.生物技术通讯2015;26(1):124-126
12蔡莉,王雨生,胡丹,等.视神经炎98例病因学临床分析.国际眼科杂志2007;7(3):734-735
13刘子豪,姜兆财,李红阳,等.双眼同时发病的视神经炎患者的临床表现、免疫学指标及转归.眼科新进展2014;34(1):41-43
14 Sun L,Weng H,Li Z.Elevation of AQP4 and selective cytokines in experimental autoimmune encephalitis mice provides some potential biomarkers in optic neuritis and demyelinating diseases.Int J Clin Exp Pathol 2015;8(12):15749-15758
15 Li SJ,Chen YH,Shao MX,et al.Association of Plasma Complement C3 Levels With Primary Angle-Closure Glaucoma in Older Women.Invest Ophthalmol Vis Sci 2017;58:682-689
16 Sabater L,Giralt A,Boronat A,et al.Cytotoxic effect of neuromyelitis optica antibody (NMO-IgG) to strocytes:An in vitro study.J Neuroimmunol 2009;215(1-2):31-35
17 Wallis R,Mitchell DA,Schmid R,et al.Paths reunited:Initiation ofthe classical and lectin pathways of complement activation.Immunobiology 2010;215(1):1-11
18 Ram S,Lewis LA,Rice PA.Infections of people with complement deficiencies and patients who have undergone splenectomy.Clin Microbiol Rev 2010;23:740-780