ABSTRACT
<p><b>OBJECTIVE</b>To assess the value of cerebral spinal fluid (CSF) and serum myelin basic protein (MBP) levels in the diagnosis of multiple sclerosis (MS).</p><p><b>METHODS</b>Enzyme-linked immunosorbent assay was used to detect the CSF and serum levels of MBP in patients with MS (n=45), patients with Guillain-Barre syndrome (GBS) (n=36) and control subjects (control) (n=33). The sensitivity and specificity of MBP in CSF and serum in the diagnosis of MS were evaluated using the receiver-operating characteristic (ROC) curves.</p><p><b>RESULTS</b>The MBP levels in CSF and serum both increased significantly in MS group as compared with those in GBS (P<0.01) and control groups (P<0.01). The area under the curve (AUC) of the ROC curve of MBP in CSF was 0.853-/+0.037 for MS diagnosis, and with the optimal cut-off value of 0.87 pg/ml, CSF MBP showed a diagnostic sensitivity of 83.7% and specificity of 78.3%. The AUC of the ROC curve of serum MBP was 0.761-/+0.046, and the optimal cut-off value of 0.25 pg/ml resulted in a diagnostic sensitivity of 62.8% and specificity of 73.9%. No statistically significant difference was found between the two AUCs (P>0.05).</p><p><b>CONCLUSION</b>Evaluation of CSF and serum MBP levels allows accurate diagnosis of MS, and MBP level in the CSF has greater diagnostic sensitivity than serum MBP. The combination of both CSF and serum MBP levels may serve as a sensitive index for the diagnosis of MS.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Early Diagnosis , Enzyme-Linked Immunosorbent Assay , Multiple Sclerosis , Diagnosis , Myelin Basic Protein , Blood , Cerebrospinal Fluid , ROC Curve , Sensitivity and SpecificityABSTRACT
Objective To analyze the risk factors for the formation of carotid atherosclerotic plaque. Methods The clinical data of 279 hospitalized patients undergoing carotid artery color Doppler ultrasonography between June 2005 and December 2006 were collected. Multiple regression of the common carotid intimal-medial thickness (IMT) was used to screen the potential risk factors of carotid plaque formation. The patients were divided into two groups according to the presence of carotid plaque, and binary logistic regression and univariate analysis were used to identify the risk factors. The carotid plaque score and index were compared between the subgroups with different risk factors. Results The common carotid IMT was subjected to influences by age (β=0.242, P=0.000), systolic blood pressure (SBP) (β=0.152, P=0.013) and the level of low-density lipoprotein (LDL) (β=0.115, P=0.048). Age (OR=1.087, P=0.000) and SBP (OR=1.036, P=0.000) were identified as the main factors that affected the formation of carotid plaque. In patients above 60 years old, the detection rate of carotid plaque was significantly higher than that in patients below 60 years (X2=58.379, P=0.000), and the rate was significantly higher in hypertensive patients than in the normotensive patients (X2=18.206, P=0.000). The carotid plaque score and index were significantly higher in patients over 60 years old than in those below 60 years (F=69.353, P=0.000;F=64.826, P=0.000, respectively), and also significantly higher in hypertensive patients than in the normohypertensive patients (F=4.866, P=0.028;F=6.927, P=0.009, respectively). Conclusion Age and SBP are the major risk factors of carotid atheroselerotie plaque formation, and LDL is a factor of lesser risk.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the association among serous and cerebrospinal fluid (CSF) TNF-alpha level, gene polymorphisms of TNF-alpha and multiple sclerosis (MS) in Han nationality of southern China.</p><p><b>METHODS</b>MS diagnosis was base on Poser (1983) criteria. Fifty-five patients with nonimmulogical diseases and 68 patients with MS from southern China were enrolled in the study, and their TNF-alpha level of serum and CSF were measured by double antibody sandwich ABC-ELISA. TNF-alpha -308G/A in 106 normal healthy subjects and 68 MS patients was genotyped with polymerase chain reaction-restriction fragment length polymorphism.</p><p><b>RESULTS</b>There was significant difference in the serous TNF-alpha level between nonimmune patients and active MS patients (234+/- 76 pg/mL vs 276+/- 71 pg/mL, P< 0.05), but not in the CSF (245+/- 83 pg/mL vs 265+/- 78 pg/mL, P> 0.05). The gene frequency distribution of TNF-alpha -308G/A was corresponding with Hardy-Weinberg equilibrium. The positive rate of genotype AA and the gene frequency of allele A of TNF-alpha were 4.4% and 14.0% in MS group, and 0 and 8.50% in healthy subjects, there was no statistical significance (P> 0.05).</p><p><b>CONCLUSION</b>The TNF-alpha level in serum is associated with active MS, but not in the CSF. The gene polymorphisms of TNF-alpha -308G/A is not associated with MS in Han nationality of southern China.</p>
