目的 比较视神经脊髓炎谱系疾病（NMOSD）与多发性硬化（MS）急性发作期脑脊液胶质纤维酸性蛋白（GFAP）水平差异，分析注射用丹参多酚酸对NMOSD的治疗效果。方法 收集2016年8月——2017年12月就诊于山西医科大学第一医院神经内科确诊患者40例，包括NMOSD患者20例，MS患者20例。采用ELISA法检测NMOSD和MS脑脊液GFAP水平。将NMOSD患者随机分为观察组和对照组，对照组采用糖皮质激素与一般神经营养药物，包括甲基强的松龙和维生素B1、B6、B12，观察组在此基础上加用注射用丹参多酚酸0.13 g，每天1次，两组均治疗14 d。治疗前后对患者进行日常生活能力（ADL）、扩展残疾状态量表（EDSS）评分。收集治疗前后的血清进行GFAP水平检测。结果 NMOSD组脑脊液GFAP水平显著高于MS组（P<0.05）。观察组和对照组用药后ADL评分组间差异无统计学意义，但观察组比对照组均数升高明显，有上升趋势；两组用药后EDSS评分组间差异无统计学意义，但观察组均数降低明显，有下降趋势；治疗后两组患者血清GFAP水平较治疗前均显著下降（P<0.001），观察组降低较对照组更显著（P<0.001）。结论 星形胶质细胞损伤引起的GFAP水平升高可以用于鉴别NMOSD与MS患者，注射用丹参多酚酸治疗急性期NMOSD，患者神经功能改善，血清GFAP水平可以间接反映NMOSD患者的病情进展。

Objective To compare the differences of cerebrospinal fluid levels of GFAP in acute attack between NMOSD and MS, and to analyze the effects of Salvianolic Acids for Injection on NMOSD. Methods Tatolly 40 patients diagnosed with neurology from the First Hospital of Shanxi Medical University were collected from August 2016 to December 2017, including 20 patients with NMOSD and 20 patients with MS. The levels of GFAP in cerebrospinal fluid of NMOSD and MS were detected by ELISA. NMOSD patients were randomly divided into treatment group and control group. The control group used glucocorticoid and general neurotrophic drugs, including methylprednisolone, vitamins B1, B6, and B12. The experimental group added salvianolic acid 0.13 g, both groups were treated for 14 days. The EDSS and ADL scores were collected before and after treatment. The serum levels of GFAP were collected before and after treatment. Results The level of GFAP in cerebrospinal fluid of NMOSD group was significantly higher than that of MS group (P<0.05); There was no significant difference in ADL scores between treatment group and control group. However, thetreatment group had a significantly higher mean than the control group, with an upward trend; There was no significant difference in the EDSS scores between treatment and control group, but the mean of the treatment group decreased significantly, with a downward trend; Serum GFAP levels decreased after treatment in both groups (P<0.001), the treatment group decreased more significantly (P<0.001). Conclusion GFAP induced by astrocyte damage can be used to identify patients with NMOSD and MS. After 14 days of treatment with Salvianolic Acids for Injection, the neurological function of patients improved. Serum GFAP levels can indirectly reflect the progression of NMOSD patients.

吴阶平医学基金会临床项目（320.6750.16130）