The Meaning Of Monitor Serum Non-ceruloplasmin Copper In Wilson Disease Anti-copper By Combined Chinese Western Therapy

Objective:Monitoring the change of serum non-ceruloplasmin bound copper, serum copper,24 h urinary copper concentration and the UWDRS sorce during the Combined Chinese Western therapy process in WD patients, and analysis of the correlation, investigation the monitoring significance about the serum non-ceruloplasmin bound copper with the nervous system symptoms changes.Method:1. Choice Select October 1, 2014 – June 1, 2015, for the first time admitted for definitive diagnosis and clinical type of cerebral type of WD patients, condition grading from I to III level.2. The anti-copper treatment DMPS IVqtt, 20mg/kg/qd, the Gandou tablets 1.35 g pro 3 times a day; the treatment group according to the UWDRS scroses before treatment and time of 4 courses, divided into restructuring, improved and no change groups.3. Outcome measures and detection methods: liver function was determined by HGST automatic biochemical Analyzer; serum copper and 24 h urinary copper concentration determination by flame atomic absorption spectrometry, serum NCBC concentration determination by ICP-AES; UWDRS nervous system scores are evaluated by two different physicians at a time, and average.4. Statistical methods and indicators: serum copper and serum NCBC copper, 24 h urinary copper and UWDRS scores correlation anaylsis by using bivariate Preason correlation test, and correlation analysis between multiple sets of variables using stepwise multiple linear regression analysis.Result:1. The results show that, by driving through DMPS combined with the tablets of Gandou treated 4 courses, 39 patients with neurological symptoms improved, 7 cases of aggravated, 8 showed no change, neurological improvement total effective rate is 72.2%;8 per course of treatment, 45 patients with neurological symptoms improved significantly, 3 cases of aggravated, 6 showed no change, neurologic improvement total effective rate 82.2%.2. Improve group during the anti-copper treatment in patients with serum copper and serum NCBC decreased(F copper =46.508, P copper <0.01; FNCBC=172.148,PNCBC<0.01). Groups of no charge during treatment of patients with no significant change in serum NCBC(F=3.132, P=0.054), serum copper 8 course of treatment than before treatment was significantly reduced(P=0.001<0.01).3. After anti-copper treatment in two groups of 24 h urine copper of patients with significantly higher content(P<0.01), improve group 8 courses of treatment 24 h urine copper more significantly reduced than 4 treatment(P<0.01), did not improved when 8courses 24 h urinary copper no significant change with 4 courses(P=0.472).4. Positively significant correlation between serum copper and UWDRS score of no charge group(r=-0.413, P=0.005) and negative relevance with 24 h of urinary copper(r=-0.285, P=0.041);To serum NCBC by multiple stepwise linear regression are the main factors influencing the results of UWDRS scores, regression equation: y(UWDRS)=45.421-0.457X2(serum NCBC). There were positively significant correlation with serum NCBC and 24 h urine copper in 8 crouse of treatment(r=0.463, P=0.004). By multiple stepwise linear regression analysis, 24 h urine copper descision by serun NCBC,regression equation: Y(24h urine copper)=2101.34-20.07X2(UWDRS)。5. Positively correlated with serum copper and the UWDRS score of no improved group before treatment(r=0.64, P=0.005), was negatively correlated with 24 h urine copper(r=-0.576, P=0.012); Positively related between with UWDRS with serum copper(r=0.723, P=0.001) and serun NCBC(r=0.662, P=0.004) in 4 courses of treatment, withand negatively correlated with urine 24 h copper(r=-0.584, P=0.011),were positively correlated with serum NCBC in the 8 courses(r=0.584, P=0.011). By multiple stepwise linear regression analysis, UWDRS neurological scores descision by serun copper and 24 h urine copper at 4 courses, regression equation: Y(UWDRS)=11.952+7.597X1(serum copper)-0.012X3(24h urine copper), and descision by serum NCBC at 8 courses, regression equation: Y(UWDRS) =4.2+0.415X2(serum copper).6. Allergies of DMPS was 22.22%,the rate of leukocyte reduction was 82.22%, and Positively significant correlation between white blood cells reduce with weighting of neurological symptoms(r=0.382, P<0.01).Conclusions:1. Gandou tables combined with DMPS anti-copper treatment can improve brain WD patients with neurological symptoms, patients with intractable cerebral WD prolonged anti-copper treatment time may contribute to the improvement of neurological symptoms.2. Anti-copper treatment serum copper and serum NCBC and 24 h copper urine levels can be used as indicators for monitoring the neurological symptoms in patients with cerebral WD, with monitoring of serum NCBC is most sensitive.