目的 探讨吗替麦考酚酯联合醋酸泼尼松对视神经脊髓炎（NMO）患者白细胞介素-23（IL-23）/IL-17A轴相关因子、复发的影响。设计 前瞻性设计。研究对象 选取我院90例NMO患者，简单随机化法分组，各30例。方法 所有患者术前均行矫正视力、Kurtzke功能评定量表（EDSS）、实验室指标检查。A组采取吗替麦考酚酯+醋酸泼尼松，B组采取吗替麦考酚酯，C组采取醋酸泼尼松，观察患者治疗3个月后、6个月后矫正视力、Kurtzke功能评定量表（EDSS）、实验室指标变化。主要指标 IL-23/IL-17A轴相关因子、矫正视力、EDSS评分、复发。结果 （1）治疗前，3组ApoE、AQP4、GFAP、IL-23、IL-17A、IL-6、TNF-α及矫正视力、EDSS评分比较差异无统计学意义（P＞0.05）；治疗3个月后、6个月后A组血清ApoE水平高于B组、C组，AQP4、GFAP、IL-23、IL-17A、IL-6、TNF-α水平低于B组、C组（P＜0.05），治疗3个月后、6个月后A组矫正视力、EDSS评分低于B组、C组（P＜0.05）；（2）3组不良反应比较差异无统计学意义（P＞0.05）；（3）3组治疗后随访12个月，A组、B组、C组各有3、3、3例失访，年复发率比较差异无统计学意义（P＞0.05）。结论 免疫抑制剂联合醋酸泼尼松可调节NMO患者神经递质、IL-23/IL-17A轴相关因子表达，改善视力，降低复发率。

目的 检测抑郁障碍患者血清中IL-2和TNF-α水平,探讨IL-2和TNF-α水平与认知功能情况相关性。方法 采用酶联免疫吸附法(ELISA)检测100例抑郁障碍患者(观察组)和100例健康人(对照组)的血清IL-2、TNF-α的水平,并结合汉密尔顿抑郁量表(HAMD)观察患者抑郁障碍的严重程度,应用Loewenstein 认知评定量表评定患者的认知状态情况进行相关分析。结果 与对照组相比,观察组的IL-2、TNF-α的水平明显更高(P<0.05)。IL-2、TNF-α的水平与HAMD,LOTCA总分呈正相关(P<0.05)。结论 抑郁障碍患者血清中IL-2、TNF-α的水平与抑郁障碍患者的严重程度和认知状态情况呈正相关。

Objective To study the levels of serum IL-2 and TNF-α in depressed patients and theircorrelations with the cognitive function. Methods 100 depressed patients (observation group) and 100 healthy people (control group) were enrolled to this study and we compared their levels of serum IL-2 and TNF-α detected by enzyme-linked immunosorbent (ELISA) from two groups. The correlation analyses of the serum IL-2 and TNF-α levels with the severity of depression of depressed patients observed with Hamilton depression scale (HAMD), and the serum IL-2 and TNF-α levels with the cognitive function evaluated with Loewenstein were conducted. Results The levels of serum IL-2 and TNF-α in the observation group were significantly higher than control group (P<0.05).There were positive correlations between the levels of IL-2 and TNF-α and HAMD scores and between the levels of IL-2 and TNF-α and LOTCA scores (P<0.05). Conclusion The levels of serum IL-2 and TNF-α in the depressed patients were positively correlative with the severity of depression and their cognitive function.