Frequin S T, Wevers R A, Braam M, Barkhof F, Hommes O R
Department of Neurology, University Hospital Nijmegen, The Netherlands.
J Neurol. 1993 May;240(5):305-8. doi: 10.1007/BF00838168.
Twenty-one patients (15 women, 6 men) with definite multiple sclerosis (MS) were treated with 1000 mg intravenous methylprednisolone-succinate (MP) daily for 10 days. Before MP treatment there was a negative correlation (r = 0.59, P = 0.0084) between serum vitamin B12 and progression rate, defined as the ratio of the score on Kurtzke's Expanded Disability Status Scale and disease duration. A significant decrease was demonstrated in the cerebrospinal fluid (CSF) and serum levels of folate and in the CSF level of vitamin B12 after MP treatment. The decrease in serum B12 was not statistically significant. After MP treatment all median levels of vitamin B12 and folate were below the reference medians. We hypothesize that low or reduced vitamin B12/folate levels found in MS patients may be related to previous corticosteroid treatments. Otherwise a more causal relationship between low vitamin B12/folate and MS cannot be excluded. Further studies may be required to clarify the vitamin B12 and folate metabolism in patients with MS.
21例确诊为多发性硬化症（MS）的患者（15名女性，6名男性）接受了为期10天的每日1000毫克静脉注射甲泼尼龙琥珀酸钠（MP）治疗。在MP治疗前，血清维生素B12与进展率之间存在负相关（r = 0.59，P = 0.0084），进展率定义为Kurtzke扩展残疾状态量表评分与病程的比值。MP治疗后，脑脊液（CSF）和血清中的叶酸水平以及CSF中的维生素B12水平均显著下降。血清B12的下降无统计学意义。MP治疗后，所有维生素B12和叶酸的中位数水平均低于参考中位数。我们推测，MS患者中发现的低维生素B12/叶酸水平可能与先前的皮质类固醇治疗有关。否则，不能排除低维生素B12/叶酸与MS之间存在更具因果关系的可能性。可能需要进一步研究来阐明MS患者的维生素B12和叶酸代谢情况。
