寡克隆条带与脑脊液细胞学检测对神经梅毒疾病的临床诊断意义

目的探讨脑脊液寡克隆条带与脑脊液细胞学对神经梅毒疾病的临床诊断意义。方法收集34例神经梅毒疾病患者血清及脑脊液,应用等电聚焦电泳技术(IEF)检测寡克隆条带,同时利用玻片离心及瑞姬染色法进行脑脊液细胞学检测,对其寡克隆阳性条带检出率及脑脊液细胞学结果进行分析。结果 34例神经梅毒疾病患者中28例寡克隆条带阳性,阳性率检出率为82.4%(28/32),脑脊液细胞学呈淋巴细胞为主的反应型(70%),伴少量激活淋巴细胞及单核细胞,偶见中性粒细胞。结论神经梅毒疾病患者脑脊液寡克隆条带检测方法较灵敏,同时脑脊液细胞学具有特征性表现,两者检测方法能够为临床诊断神经梅毒疾病提供依据,具有一定的临床价值。     

肌萎缩侧索硬化患者脑脊液免疫指标检测的意义

目的分析肌萎缩侧索硬化患者血脑屏障通透性、IgG合成率、IgG指数、寡克隆区带等免疫指标变化。方法选择1996-01/2002-12北京大学第一医院神经免疫研究室脑脊液和血配对标本库中筛选确诊的肌萎缩侧索硬化患者29例,男24例,女5例。同期选择本院神经系统非炎症性疾病患者35例和32例骨科腰部疾患或下肢部位手术腰部麻醉者为对照组,男42例,女25例。所有患者同时采静脉血和脑脊液各2mL,检测两组患者血脑屏障通透性异常阳性率(<7×10-3为异常)、IgG合成异常率(<7mg为异常)、IgG指数异常率(<0.7为异常)和寡克隆区带的异常率(以脑脊液中有不同于血清的条带为阳性)。结果对照组67例和肌萎缩侧索硬化组29例患者均进入结果分析。对照组血脑屏障通透性异常阳性率、IgG合成率异常阳性率、IgG指数异常阳性率、寡克隆区带阳性率均为阴性。肌萎缩侧索硬化组分别为21%(6/29),69%(20/29),83%(24/29),41%(12/29),两组比较均有显著性意义(χ2=27.845,67.379,73.149,31.770,P<0.05)。结论肌萎缩侧索硬化患者中枢神经组织有免疫介导损伤的血脑屏障破坏和免疫反应异常。     

多发性硬化患者脑脊液寡克隆区带及IgG指数、IgG的合成率分析

目的:探讨多发性硬化患者脑脊液寡克隆区带、IgG指数及IgG合成率的临床意义。方法:于2004-10/2005-12选择中山大学附属第三医院神经病学科收治多发性硬化患者32例的脑脊液及血清配对标本进行观察,其中传统型多发性硬化患者18例,视神经脊髓炎患者14例。对照组选择中枢神经系统感染性疾病患者42例,中枢神经系统非感染性疾病患者38例,外周神经系统疾病患者32例。采取散射比浊法测定脑脊液及配对血清中IgG、白蛋白含量,通过公式计算IgGDelpech指数及IgGTourtellotte合成率;使用等电聚焦法 生物素-亲和素-过氧化物酶法检测脑脊液寡克隆区带。结果:纳入患者144例,均进入结果分析。①多发性硬化患者寡克隆区带阳性率高于中枢神经系统非感染患者及外周疾病患者,差异有显著性意义(分别为37.50%,5.26%,0,P<0.05)。②多发性硬化组寡克隆区带、IgG指数、IgG合成率阳性情况高于对照组,差异有显著性意义(分别为37.50%,10.71%;31.25%,7.14%;37.50%,8.92%,P<0.05)。③寡克隆区带阳性多发性硬化患者脑脊液中白细胞计数和总蛋白含量高于寡克隆区带阴性患者,差异有显著性意义[分别为(10.93±5.41)×106,(2.99±1.33)×106;(0.27±0.06),(0.19±0.06)g/L,P<0.05];两者IgG指数比较差异无显著性意义(P>0.05)。结论:中国多发性硬化患者寡克隆区带阳性率较低,非多发性硬化患者也可出现寡克隆区带;寡克隆区带、IgG指数和IgG合成率对中国多发性硬化诊断有一定参考价值,但必须结合使用;寡克隆区带阳性与阴性多发性硬化患者存在脑脊液白细胞及蛋白含量的差异。     

肌萎缩侧索硬化患者神经干细胞移植后中枢内的体液免疫反应

背景:尽管中枢神经系统是"免疫特赦区",但有研究显示出宿主对神经干细胞存在排斥,从临床安全性考虑,加深神经干细胞移植免疫学的研究极其必要.目的:研究肌萎缩侧索硬化患者神经干细胞移植后中枢内的体液免疫反应模式.设计:病例分析.对象:2006-09/2007-06武装警察部队总医院收治的肌萎缩侧索硬化患者32例,均符合EL Escorial诊断标准,经影像学和Queckenstedt试验确定不存在蛛网膜下腔阻塞,男21例,女11例,平均年龄(51±10)岁,其中有8例曾于6个月前行1个疗程神经干细胞移植治疗.神经干细胞取自流产胎儿的脑组织,产妇及家属均签署捐赠同意书,实验经医院医学伦理委员会批准.方法:1个疗程共行4次神经干细胞移植,每次移植所分离培养的神经干细胞4.0×106个,1次/周,其中3次经腰穿途径,1次经脑实质内移植途径.于首次移植前和末次移植后分别配对采取脑脊液和晨起空腹血清各2 mL,用散射比浊法平行测定配对脑脊液和血清中的白蛋白、IgG、IgA、IgM浓度.主要观察指标:以脑脊液/血清白蛋白浓度商来反映血-脑脊液屏障功能,检测免疫球蛋白鞘内合成率.结果:与细胞移植前比较,移植后32例患者脑脊液/血清白蛋白浓度商均明显增加(P < 0.05),脑脊液中IgG、IgA、IgM浓度均显著升高(P < 0.05).移植前32例患者各类免疫球蛋白鞘内合成率均< 0,未发现鞘内免疫球蛋白合成;移植后1例女性患者IgA鞘内合成率为24.3%,1例男性患者IgM鞘内合成率为7.0%,余30例患者仍未发现有鞘内免疫球蛋白合成.结论:脑脊液内免疫球蛋白浓度升高是因脑脊液/血清白蛋白浓度商升高引起而非鞘内合成,植入物并未引起可以探测到的中枢内体液免疫反应.     

肌萎缩侧索硬化患者脑脊液免疫指标检测的意义

目的分析肌萎缩侧索硬化患者血脑屏障通透性、IgG合成率、IgG指数、寡克隆区带等免疫指标变化．方法 选择1996-01／2002-12北京大学第一医院神经免疫研究室脑脊液和血配对标本库中筛选确诊的肌萎缩侧索硬化患者29例，男24例，女5例。同期选择本院神经系统非炎症性疾病患者35例和32例骨科腰部疾患或下肢部位手术腰部麻醉者为对照组，男42例，女25例。所有患者同时采静脉血和脑脊液各2mL，检测两组患者血脑屏障通透性异常阳性率（〈7&;#215;10^-3为异常）、IgG合成异常率（〈7mg为异常）、IgG指数异常率（〈0．7为异常）和寡克隆区带的异常率（以脑脊液中有不同于血清的条带为阳性）。结果 对照组67例和肌萎缩侧索硬化组29例患者均进入结果分析。对照组血脑屏障通透性异常阳性率、IgG合成率异常阳性率、IgG指数异常阳性率、寡克隆区带阳性率均为阴性。肌萎缩侧索硬化组分别为21％（6／29），69％（20／29），83％（24／29），41％（12／29），两组比较均有显著性意义（X^2=27．845，67．379，73．149，31．770，P〈0．05）。结论肌萎缩侧索硬化患者中枢神经组织有免疫介导损伤的血脑屏障破坏和免疫反应异常。     

41例梅毒患者脑脊液检测结果分析

目的分析梅毒患者脑脊液的实验室检查结果,探讨脑脊液检查在神经梅毒诊断中的价值。方法回顾性分析本院2015年11月～2016年10月收治的41例梅毒患者脑脊液的甲苯胺红不加热血清试验(TRUST)、梅毒螺旋体特异性抗体明胶凝集试验(TPPA),以及常规、生化和免疫球蛋白IgG检查的结果。结果确诊神经梅毒13例,神经梅毒疑似4例,排除神经梅毒24例。41例梅毒患者脑脊液检查中,TRUST阳性9例;TPPA阳性17例;白细胞升高(10×10~6/L)3例(3/13);蛋白异常(0.6 g/L)7例(7/13),IgG升高(34 mg/L)11例(11/13);葡萄糖和氯化物基本正常;神经梅毒组与非神经梅毒组比较,脑脊液检查相关指标的差异有统计学意义。结论神经梅毒发病隐匿,症状无特异性,易造成误诊或漏诊,对疑似病例应尽早做脑脊液相关检查,可为神经梅毒的早期诊断和治疗提供重要依据。     

多发性硬化患者脑脊液寡克隆区带及IgG指数、IgG的合成率分析

目的：探讨多发性硬化患者脑脊液寡克隆区带、IgG指数及IgG合成率的临床意义。 方法：于2004-10／2005-12选择中山大学附属第三医院神经病学科收治多发性硬化患者32例的脑脊液及血清配对标本进行观察，其中传统型多发性硬化患者18例，视神经脊髓炎患者14例。对照组选择中枢神经系统感染性疾病患者42例，中枢神经系统非感染性疾病患者38例，外周神经系统疾病患者32例。采取散射比浊法测定脑脊液及配对血清中IgG、白蛋白含量，通过公式计算IgG Delpech指数及IgG Tourtellotte合成率；使用等电聚焦法＋生物素一亲和素一过氧化物酶法检测脑脊液寡克隆区带。 结果：纳入患者144例，均进入结果分析。①多发性硬化患者寡克隆区带阳性率高于中枢神经系统非感染患者及外周疾病患者，差异有显著性意义（分别为37．50％，5．26％，0，P〈0．05）。②多发性硬化组寡克隆区带、IgG指数、IgG合成率阳性情况高于对照组，差异有显著性意义（分别为37．50％，10．71％；31．25％，7．14％；37．50％，8．92％，P〈0．05）。③寡克隆区带阳性多发性硬化患者脑脊液中白细胞计数和总蛋白含量高于寡克隆区带阴性患者，差异有显著性意义[分别为（10．93&;#177;5．41）&;#215;10^6，（2．99&;#177;1.33）&;#215;10^6；（0．27&;#177;0．06），（0．19&;#177;0．06）g／L，P〈0．05]；两者IgG指数比较差异无显著性意义（P〉0．05）。 结论：中国多发性硬化患者寡克隆区带阳性率较低，非多发性硬化患者也可出现寡克隆区带；寡克隆区带、IgG指数和IgG合成率对中国多发性硬化诊断有一定参考价值，但必须结合使用；寡克隆区带阳性与阴性多发性硬化患者存在脑脊液白细胞及蛋白含量的差异。     

免疫固定电泳和免疫球蛋白含量在多发性骨髓瘤诊断中价值

目的探讨免疫固定电泳技术和免疫球蛋白含量在多发性骨髓瘤(multiple myeloma,MM)诊断和分型中的应用价值。方法 140例MM患者为MM组,对其血清和尿液进行免疫固定电泳检查,免疫固定电泳采用琼脂糖电泳和免疫固定技术。选择同期体检健康者32例为正常对照组,采用速率散射比浊法检测2组血清免疫球蛋白(IgG、IgM、IgA)含量。结果 MM组患者血清经免疫固定电泳后均呈现浓集条带,M蛋白检出率为100.0%,IgG型92例(65.7%),其中IgGκ型61例,IgGλ型31例;IgM型28例(20.0%),其中IgMκ型19例,IgMλ型9例;IgA型20例(14.3%),其中IgAκ型9例,IgAλ型11例;尿液经免疫固定电泳后呈现明显浓集条带患者89例,M蛋白检出率为63.6%;免疫球蛋白含量检测显示,MM组IgG型患者IgG含量[(34.92±21.02)g/L]明显高于对照组[(11.62±6.38)g/L],IgM[(0.65±0.42)g/L]和IgA[(1.01±0.86)g/L]含量明显低于对照组[(1.23±0.56)、(2.31±1.48)g/L](P0.05);IgM型患者IgM含量[(19.50±13.20)g/L]明显高于对照组,IgG[(7.85±6.62)g/L]和IgA[(1.42±0.77)g/L]含量明显低于对照组(P0.05);IgA型患者IgA含量[(15.00±11.00)g/L]明显高于对照组,IgG[(6.52±4.86)g/L]和IgM[(0.52±0.33)g/L]含量明显低于对照组(P0.05)。结论免疫球蛋白含量可协助诊断MM,采用免疫固定电泳技术对M蛋白进行分型和鉴定,对MM的诊断分型及预后判断有重要意义。     

Protis分析软件在评价神经系统疾病患者鞘内IgG合成与血脑屏障功能损伤中的应用

目的 分析多发性硬化患者和其他神经系统疾病患者鞘内IgG合成及血脑屏障功能状态,以探讨Protis分析软件和传统脑脊髓液(CSF)IgG生成指数以及24 h IgG合成率在评价神经系统疾病患者鞘内局部IgG合成与血脑屏障功能障碍中的应用价值.方法 用BN-Ⅱ特定蛋白分析仪检测34例多发性硬化患者、80例其他神经系统疾病患者、20例CSF正常患者血和CSF中白蛋白(ALB)、IgG含量,并用CSF免疫固定电泳检测IgG寡克隆区带.用传统公式分析计算IgG生成指数和24 h IgG合成率,并将数据输入Protis软件分析,得出鞘内IgG合成率(IgGIF).结果 多发性硬化组血脑屏障功能基本正常,白蛋白商值(QALB)为4.5×10-3[(3.1～7.6)×10-3],且与CSF正常对照组差异无统计学意义(D=5.25,P>0.05),多发性硬化组34例患者中有31例患者寡克隆区带检测阳性,阳性率为91.2%;鞘内IgGIF、IgG生成指数及24 h IgG合成率为31.25%(11.65%～71.45%),0.93(0.80～1.04),24.25 mg/24 h(15.25～46.15 mg/24 h),均高于CSF正常对照组(D=175.5、112.5、103.4,P均<0.05);而多发性硬化组的鞘内IgGIF、IgG生成指数及24 h IgG合成率与寡克隆区带检测阳性率的差异无统计学意义(P均>0.05).其他神经系统疾病组QALB为35.2×10-3[(18.5～55.5)×10-3],显著高于CSF正常对照组(D=102.7,P<0.05),80例患者寡克隆区带检测全部为阴性,IgG生成指数及24 h IgG合成率结果分别为0.75(0.69～0.82)、44.29 mg/24 h(20.35～65.98 mg/24 h),均高于CSF正常对照组(D=85.6、98.5,P均<0.05),其他神经系统疾病对照组鞘内IgGIF阳性率为0(0/80),IgG生成指数阳性率为40.0%(32/80),24 h IgG合成率阳性率72.5%(58/80).此外,IgG生成指数随血脑屏障功能损害程度的加深呈递增趋势(P<0.05),同时其假阳性率也随血脑屏障功能损害程度的加深逐渐增加(P<0.05);24 h IgG合成率结果也存在同样的变化趋势.在多发性硬化组鞘内IgGIF与IgG生成指数和24 h IgG合成率均存在显著相关性(r=0.788、0.695,P均<0.05);在其他神经系统疾病患者中鞘内IgGIF与IgG生成指数和24 h IgG合成率不存在相关性(r值均为0.000,P均>0.05).结论 用Protis软件分析得出的鞘内IgGIF,可更准确地反映出患者鞘内IgG合成情况,Protis分析软件在神经系统疾病的实验室诊断中具有较好的应用价值.     

脑脊液细胞学在神经梅毒中的诊断价值

目的　观察神经梅毒患者的脑脊液细胞学变化特点 ,探讨其诊断价值。方法　对 32例脑脊液标本进行离心染色 ,同时进行细胞计数、生化、梅毒血清非特异性试验 (RPR)、梅毒血清特异性试验 (TPHA)检查。结果　发现10例神经梅毒患者的脑脊液细胞学异常率 10 0 % ;2 2例无神经系统损害的梅毒患者异常率 4 5 .5 % (10 / 2 2 ) ,明显高于脑脊液细胞计数、RPR检查 (P <0 .0 5 ) ,而与TPHA、生化检查结果大致相当 (P >0 .0 5 )。结论　梅毒患者未出现神经系统损害以前在中枢神经系统已有免疫反应发生 ,脑脊液细胞学对神经梅毒早期诊断、早期预防方面具有一定价值。     

Quality assurance for cerebrospinal fluid protein analysis: international consensus by an Internet-based group discussion.

A group of neurologists and clinical neurochemists representing twelve countries worked towards a consensus on laboratory techniques to improve the quality of analysis and interpretation of cerebrospinal fluid (CSF) proteins. Consensus was approached via a virtual Lotus Notes-based TeamRoom. This new approach respecting multicultural differences, common views, and minority opinions, is available in http://www.teamspace.net/ CSF, presenting the implicit, complementary version of this explicit, printed consensus. Three key recommendations were made: CSF and (appropriately diluted) serum samples should be analyzed together in one analytical run, i.e., with reference to the same calibration curve. Results are evaluated as CSF/serum quotients, taking into account the non-linear, hyperbolic relation between immunoglobulin (Ig)- and albumin-quotients rather than using the linear IgG index or IgG synthesis rate. Controls should include materials with values within the reference ranges (IgM: 0.5-1.5 mg/l; IgA: 1-3 mg/l; IgG: 10-30 mg/l and albumin: 100-300 mg/l). The physiological, methodological and clinical significance of CSF/serum quotients is reviewed. We confirmed the previous consensus on oligoclonal IgG, in particular the usefulness of the five typical interpretation patterns. The group compared current external and internal quality assurance schemes and encouraged all members to maintain national or local traditions. Values for acceptable imprecision in the CSF quality assurance are proposed.     

Oligoclonal immunoglobulin M in the cerebrospinal fluid of patients with Garin-Bujadoux-Bannwarth meningopolyneuritis

Paired cerebrospinal fluid (CSF) and serum samples from 15 patients with meningopolyneuritis Garin-Bujadoux-Bannwarth (MPN-GBB) were investigated by agarosegel electrophoresis (AE) and consecutive immunofixation (IF). Oligoclonal immunoglobulin (Ig) was detected in the CSF in 13 cases, 8 of which showed oligoclonal IgM; oligoclonal Ig was not found in the respective serum samples. Local CSF synthesis of IgM is a characteristic feature in patients with MPN-GBB. Further serological testing for borreliosis is mandatory in such cases.     

Cytological and immunological examination of cerebrospinal fluid in 9 patients with Ramsay Hunt's syndrome

The purpose of the present study was to carry out the immunological and cytological examination of cerebrospinal fluid in 9 patients with Ramsay Hunt's syndrome. The results obtained were as follows: Among the serum immunoglobulins, IgG in 1 and IgM in 5 of 9 cases increased. The Varicella Zoster antibody titer was significantly elevated in sera of all 9 cases and in CSF of all 7 examined cases. There ws positive fluorescence to Varicella Zoster virus in 2 (Cases 8 and 9) of 4 cases in which CSF smears were examined. The cells showing fluorescence were 10.5% in the former and 1.5% in the latter. Pleocytosis was found in all cases and CSF cell counts ranged from 52 to 2,000/3 mm3 in the early stage. In 3 cases immunoglobulin containing cells (IgG and IgM) were seen about 2-20% within 2 weeks of onset. IgG contents in all and IgG% in 8 of 9 cases, IgA concentration in 7 and IgA% in 7 of 9 cases were increased. These results support the view that the Varicella Zoster virus spreads to the meninges and CSF from ganglions in patients with Ramsay Hunt's syndromes.     

三种脑部炎症病变脑脊液铁蛋白、脑脊液白蛋白/血清白蛋白比值和免疫球蛋白的变化及意义

目的　探讨结核性脑膜炎、病毒性脑膜炎、急性播散性脑脊髓炎脊液铁蛋白、脑脊液白蛋白 /血清白蛋白比值及脊液免疫球蛋白的变化及诊断意义。方法　检测结核性脑膜炎 31例、病毒性脑膜炎 32例、急性播散性脑脊髓炎 30例患者的脑脊液铁蛋白、脑脊液白蛋白 /血清白蛋白比值及脊液免疫球蛋白的变化 ,并与 30例正常者作对照。结果　方差分析显示结核性脑膜炎、病毒性脑膜炎、急性播散性脑脊髓炎及对照组脑脊液铁蛋白、脑脊液白蛋白 /血清白蛋白比值差异均有统计学意义 (P <0 .0 0 0 1) ,3组脑部疾病间的铁蛋白、脑脊液白蛋白 /血清白蛋白比值差异均有统计学意义 (P均 <0 .0 5 )。方差分析结核性脑膜炎、病毒性脑膜炎及急性播散性脑脊髓炎脑脊液IgA、IgM、IgG变化差异有统计学意义 (P <0 .0 0 0 1) ,结核性脑膜炎组脑脊液IgA、IgM较急性播散性脑脊髓炎及病毒性脑膜炎显著升高(P <0 .0 5 ) ,急性播散性脑脊髓炎IgG较结核性脑膜炎及病毒性脑膜炎显著升高 (P <0 .0 5 )。结论　结核性脑膜炎、病毒性脑膜炎、急性播散性脑脊髓炎脊液铁蛋白、脑脊液白蛋白 /血清白蛋白比值和脊液免疫球蛋白的变化和差异 ,可作为诊断和鉴别诊断的参考指标。     

Diagnosis of neurosyphilis: a critical assessment of current methods

Clinical features of 74 patients with neurosyphilis and 38 syphilitic patients with nonsyphilitic neurologic disorders were correlated with results of their serum and cerebrospinal fluid (CSF) VDRL and FTA tests, and with the WBC count and total protein level in the CSF. The most common clinical features in those having neurosyphilis were reflex changes (53.9%), peripheral neuropathy (44.5%), ataxia (38%), and cranial nerve palsies (24.3%). In 27% of the patients with neurosyphilis the CSF was VDRL-reactive, while in 77% the CSF was FTA-reactive. The frequency of elevated WBC counts in various serologic categories ranged from 23% to 46%, and the frequency of elevated protein levels ranged from 23% to 27%; neither the mean WBC count nor the protein level differed significantly among the different serologic categories (P less than .05). Only two of the 74 patients with neurosyphilis had elevation of both the WBC and protein level. None of the syphilitic patients without neurosyphilis had an elevated WBC or protein level, though the CSF was FTA-reactive in all 38. Among the neurosyphilis patients whose CSF was VDRL-nonreactive but FTA-reactive, 21% had an elevated protein level and 26% had an elevated WBC count. These results support the view that patients having neurosyphilis will not necessarily have either VDRL-reactive CSF or the other expected CSF abnormalities.     

Application of two monoclonal antibodies to either an immunosorbent enzyme assay or a competitive binding enzyme immunoassay for human serum pancreatic lipase

An immune response within the central nervous system (CNS) is reflected by an increase of immunoglobulin concentrations in the cerebrospinal fluid. IgM is considered the first class of immunoglobulins to be increased after infection. Calculation of the IgM and IgG-index reflects immunological activity within the CNS. Insight in this activity is essential in the diagnosis of several neurological diseases, especially neurosyphilis. A new fast solid phase, double sandwich enzyme-immuno assay for the measurement of IgM in the CSF is described and applied in 71 neurovenereological patients.     

Cerebrospinal fluid IgG and IgM indexes as indicators of active neurosyphilis

Serological and non-serological tests were performed in matched samples of cerebrospinal fluid and serum from 236 syphilitic patients. An increased IgG or IgM index, or both, was found about 70 times more often in symptomatic neurosyphilis than in latent syphilis without involvement of the central nervous system. An increased Ig index, together with a cell count greater than 5/microL, was only found in symptomatic neurosyphilis. Although the numbers of data are small, we conclude that the IgG and IgM indexes are valuable tests in the diagnosis of syphilitic involvement of the central nervous system.     

Reference values for CSF-IgM, CSF-IgM/S-IgM ratio and IgM index, and its application to patients with multiple sclerosis and aseptic meningoencephalitis

Immunoglobulin M (IgM) concentrations were determined in cerebrospinal fluid (CSF) and serum (S) by enzyme-linked immunosorbent assay (ELISA). In 52 reference subjects, the upper reference limit was 0.46 mg/l for CSF-IgM, 0.32 X 10(-3) for CSF-IgM/S-IgM ratio, and 0.061 for IgM index equal to CSF-IgM X S-albumin/S-IgM X CSF-albumin ratio. No correlation to age over 15-85 years was found for any of these variables. Among 22 patients with aseptic meningoencephalitis (AM) elevated values of CSF-IgM were found in 68%, CSF-IgM/S-IgM ratio in 73%, and IgM index in 73%. The corresponding values among 35 patients with multiple sclerosis (MS) were 66%, 60% and 63%. The differences in diagnostic sensitivities for the three IgM variables were not significant. Eleven of 16 AM patients and two of 22 with MS had elevated IgM index in the presence of normal IgG and IgA indices. Determination of IgM index should therefore be performed in suspected inflammatory nervous system disorders.     

Protis系统在脑脊液蛋白质分析中的临床应用和评价

目的探讨分析软件Protis在脑脊液(CSF)蛋白质分析中的临床实用价值。方法用散射比浊法平行测定32例患者CSF与血清中免疫球蛋白(IgG、IgA、IgM)和白蛋白(A lb)的含量,并利用分析软件Protis进行数据和图形处理。结果正常11例,单纯血脑屏障受损12例,仅有鞘内合成6例,血脑屏障受损伴有鞘内合成3例。结论Protis软件能辅助临床对中枢神经系统疾病作出初步的鉴别诊断结论,其报告方式为临床提供了一种快速、可靠、直观、系统的辅助诊断手段,值得广泛推广。