Department of Ophthalmology, Emory University School of Medicine, United States.
Department of Ophthalmology, Emory University School of Medicine, United States; Department of Neurology, Emory University School of Medicine, United States; Department of Epidemiology, Emory University School of Medicine, United States.
J Neurol Sci. 2017 Oct 15;381:226-229. doi: 10.1016/j.jns.2017.08.3264. Epub 2017 Sep 1.
To evaluate the relationship between CSF total protein concentration (CSF protein) and CSF opening pressure in idiopathic intracranial hypertension (IIH), and to explore the association of age, gender, race, BMI, and Humphrey visual field mean deviation (HVF MD) with CSF total protein.
The medical records of all IIH patients seen between 1989 and 2016 at one institution were systematically reviewed for demographics, CSF opening pressure, CSF contents, and HVF MD (at initial evaluation and most recent follow-up). Linear regression of CSF protein on CSF opening pressure was performed also considering BMI, age, gender, race, HVF MD, and year of lumbar puncture.
We included 266 IIH patients (13 pre-pubertal children, 35 post-pubertal children, 218 adults). There was a negative linear association between CSF opening pressure and CSF protein: CSF protein decreased by 0.18mg/dL for each 1cm HO increase in CSF opening pressure (p<0.001). After controlling for CSF opening pressure, mean CSF protein was 4.1mg/dL higher in white patients than in black patients (p<0.001). Multivariable analysis found that CSF opening pressure (p=0.007), white race (p<0.001), and HVF MD (most recent follow-up, worst eye, p=0.05) remained independently associated with CSF protein controlling for year of lumbar puncture and age.
There was a negative association between CSF protein and CSF opening pressure. After controlling for CSF opening pressure, CSF protein was higher in white patients and unaffected by age, gender, or BMI. Our findings help clarify inconsistent results of prior studies, but do not really help clarify IIH pathophysiology.
评估特发性颅内高压（IIH）患者脑脊液总蛋白浓度（CSF 蛋白）与脑脊液开放压之间的关系，并探讨年龄、性别、种族、BMI 和 Humphrey 视野平均偏差（HVF MD）与 CSF 总蛋白的关系。
系统回顾了 1989 年至 2016 年在一家机构就诊的所有 IIH 患者的病历，以获取人口统计学、脑脊液开放压、脑脊液内容物和 HVF MD（在初始评估和最近随访时）的数据。还考虑了 BMI、年龄、性别、种族、HVF MD 和腰椎穿刺年份，对 CSF 蛋白与 CSF 开放压进行了线性回归分析。
我们纳入了 266 例 IIH 患者（13 例青春期前儿童、35 例青春期后儿童、218 例成人）。CSF 开放压与 CSF 蛋白之间呈负线性关系：CSF 蛋白随 CSF 开放压每增加 1cmHO 而降低 0.18mg/dL（p<0.001）。在控制 CSF 开放压后，白种患者的平均 CSF 蛋白比黑种患者高 4.1mg/dL（p<0.001）。多变量分析发现，CSF 开放压（p=0.007）、白种人（p<0.001）和 HVF MD（最近随访时最差眼，p=0.05）在控制腰椎穿刺年份和年龄后仍与 CSF 蛋白独立相关。
CSF 蛋白与 CSF 开放压之间存在负相关。在控制 CSF 开放压后，白种患者的 CSF 蛋白较高，不受年龄、性别或 BMI 的影响。我们的研究结果有助于澄清先前研究结果的不一致，但并不能真正阐明 IIH 的病理生理学。
