摘要
目的探讨脑脊液寡克隆区带(oligoclonal bands,OCB)在多发性硬化(multiple sclerosis,MS)中的意义。方法收集神经系统疾病患者895例,其中MS患者151例,视神经脊髓炎(neuromyelitis optica,NMO)患者92例,其他神经系统脱髓鞘疾病(other demyelinating diseases,ODD)患者122例,其他神经系统炎性疾病(other inflammatory neurological diseases,IND)患者99例,神经系统非炎性疾病(noninflammatory neurologicaldiseases group,NIND)患者431例。检测所有患者的OCB、IgG指数及24hIgG合成率,比较各组OCB阳性、IgG指数及24hIgG合成率升高情况,并比较OCB阳性和阴性MS患者的主要临床特点。结果 OCB阳性率MS组为32.45%,NMO组为20.65%,ODD组为18.03%,IND组为16.16%,NIND组为2.09%;IgG指数升高比例MS组为29.8%,NMO组为17.39%,ODD组为16.39%,IND组为15.15%,NIND组为1.62%;24hIgG合成率升高比例MS组为30.46%,NMO组为18.48%,ODD组为18.85%,IND组为19.19%,NIND组为1.39%。OCB阳性率、IgG指数和24hIgG合成率升高比例MS组均高于其他各组(均P<0.05);NMO组与ODD组、IND组的OCB阳性率、IgG指数和24hIgG合成率升高比例无统计学差异(均P>0.05);MS组、NMO组、ODD组及IND组OCB阳性率均高于NIND组(均P=0.000)。OCB阳性MS患者的女性比例、EDSS评分、IgG指数和24hIgG合成率〔分别为女∶男2.5∶1、(4.10±1.49)、(0.81±0.31)、(4.98±3.35)〕均高于OCB阴性患者〔分别为女∶男1.17∶1、(3.47±1.39)、(0.51±0.17)、(3.37±3.20)〕(均P<0.05)。结论与其他中枢神经系统疾病相比,MS患者的OCB阳性率更高。OCB阳性MS患者的女性比例、EDSS评分、IgG指数和24hIgG合成率均高于OCB阴性患者。
Objective To evaluate the clinical significance of oligoclonal bands （OCB） for multiple sclerosis （MS）.Methods 895 patients with neurological diseases were divided into 5 groups：151 patients in MS group,92 patients in neuromyelitis optica （NMO） group,122 patients in other demyelinating diseases （ODD） group,99 patients in other inflammatory neurological diseases （IND） group,and 431 patients in noninflammatory neurological diseases （NIND） group.Cerebrospinal fluid OCB,IgG index and 24 h IgG synthesis rate were detected in all patients.The results were compared among the 5 groups.And clinical manifestations were compared between MS patients with different OCB status.Results OCB positive rate was 32.45％ in the MS group,20.65％ in the NMO group,18.03％ in the ODD group,16.16％ in the IND group,and 2.09％ in the NIND group.The rate of elevated IgG index was 29.8％ in the MS group,17.39％ in the NMO group,16.39％ in the ODD group,15.15％ in the IND group,and 1.62％ in the NIND group.Elevated 24 h IgG synthesis rate was 30.46％ in the MS group,18.48％ in the NMO group,18.85％ in the ODD group,19.19％ in the IND group,and 1.39％ in the NIND group.OCB positive rate,elevated IgG index and 24 h IgG synthesis rate in the MS group were higher than those in other groups （all P＜0.05） ; there was no significant difference in the OCB positive rate,frequencies of elevated IgG index and 24 h IgG synthesis between the NMO,ODD and IND groups （all P＞0.05）; OCB positive rate in NIND patients was the lowest among all groups （all P=0.000）.OCB positive MS patients had higher female ratio,EDSS score,elevated IgG index and 24 h IgG synthesis rate [2.5 ∶1,（4.10 ± 1.49）,（0.81 ±0.31）,（4.98±3.35）,respectively] than OCB negative patients [1.17.∶ 1,（3.47±1.39）,（0.51 ±0.17）,（3.37 ±3.20）,respectively].Conclusions OCB positive rate is higher in MS than other nervous system diseases in Chinese populations.OCB positive MS patients have higher female ratio,EDSS score,elevated IgG index and 24 h IgG synthesis rate than OCB negative patients.
出处
《中国神经免疫学和神经病学杂志》
CAS
北大核心
2013年第3期153-155,159,共4页
Chinese Journal of Neuroimmunology and Neurology
基金
中山大学临床医学研究"5010计划"基金资助项目
国家自然科学基金资助项目(81171126)
关键词
寡克隆区带
多发性硬化
视神经脊髓炎
oligoclonal bands
multiple sclerosis
neuromyelitis optica
