Markers of nerve tissue injury in the cerebrospinal fluid in patients with lumbar disc herniation and sciatica
Markers of nerve tissue injury in the cerebrospinal fluid in patients with lumbar disc herniation and sciatica
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DOI：
10.1097/00007632-199904150-00003
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发表时间：
1999-04-15
期刊：
影响因子：
3
通讯作者：
Rydevik, B
中科院分区：
文献类型：
--
作者：
Brisby, H;Olmarker, K;Rydevik, B
研究设计：对腰椎间盘突出症患者和对照组脑脊液中神经丝蛋白轻亚单位、S-100蛋白、神经元特异性烯醇化酶和胶质纤维酸性蛋白进行检测。目的：确定腰椎间盘突出症所致神经根损伤是否会增加脑脊液中神经和胶质细胞损伤标志物的水平。可以在脑脊液中分析神经组织损伤的标志物，从而确定神经疾病患者所涉及的细胞类型和疾病程度。对接受腰椎间盘突出症手术的患者和接受下肢手术的患者(对照组)进行术前腰椎穿刺术前采集脑脊液样本。用酶联免疫吸附试验检测神经丝蛋白(轻亚单位)和胶质纤维酸性蛋白，用放射免疫法和发光免疫法分别检测S-100蛋白和神经元特异性烯醇化酶。在腰椎间盘突出组中，评估了四种标记物的浓度与患者病史、计算机断层扫描结果和临床表现的可能相关性。腰椎间盘突出组脑脊液中神经丝蛋白(轻亚单位)和S-100浓度较对照组升高(分别为1158+/-383 ng/L vs.152+/-14 ng/L，P<0.01；1963+/-231 ng/L vs.1003+/-152 ng/L，P<；0.05)。神经元烯醇化酶和胶质纤维酸性蛋白浓度在两组之间没有统计学差异。主观症状持续时间<3个月的腰椎间盘突出症患者的神经丝蛋白水平高于持续时间较长的患者。这些标记物均与术前临床或计算机断层扫描结果无关。术后2-3个月随访有持续性神经学改变的患者与无后遗症的患者相比，术前神经丝蛋白水平升高。腰椎间盘突出症和坐骨神经痛患者脑脊液中神经丝蛋白和S-100浓度升高，提示神经根轴突和雪旺细胞受损。
Study Design, The light subunit of neurofilament protein, S-100 protein, neuron-specific enolase, and glial fibrillary acidic protein were determined in the cerebrospinal fluid in patients with lumbar disc herniation and in control patients.Objectives, To determine whether nerve root injury caused by disc herniation increases the levels of nerve and glial cell injury markers in the cerebrospinal fluid.Summary of Background Data. Markers of nerve tissue injury can be analyzed in the cerebrospinal fluid, allowing characterization of the cell types involved and the degree of disease in patients with neurologic disorders.Methods. Cerebrospinal fluid samples were obtained by preoperative lumbar puncture in patients who underwent surgery for lumbar disc herniation and in patients who underwent lower extremity surgery (control group). neurofilament protein (light subunit) and glial fibrillary acidic protein were analyzed by enzyme-linked immunosorbent assay and S-100 protein and neuron-specific enolase by radioimmunoassay and luminescence immunoassay, respectively. In the disc herniation group the concentrations of the four markers were evaluated regarding possible correlation to patient history, computed tomographic findings, and clinical findings.Results. Cerebrospinal fluid concentration of neurofilament protein (light subunit) and S-100 were increased in the disc herniation group compared with that in control subjects (1158 +/- 383 ng/L vs. 152 +/- 14 ng/L, P < 0.01; 1963 +/- 231 ng/L vs. 1003 +/- 152 ng/L, P < 0.05, respectively). No statistical differences in neuron-specific enolase and glial fibrillary acidic protein concentrations were observed between the groups. Disc herniation patients with fewer than 3 months' duration of subjective symptoms had higher neurofilament protein levels than did patients with longer duration. None of the markers was related to preoperative clinical or computed tomographic findings. Patients with persistent neurologic findings at follow-up 2-3 months after surgery had higher levels of neurofilament protein before surgery compared with those without sequelae.Conclusions. Patients with disc herniation and sciatica have increased concentrations of neurofilament protein and S-100 in the cerebrospinal fluid, which indicates damage of axons and Schwann cells in the affected nerve root.