视神经脊髓炎特异性IgG抗体对视神经脊髓炎的诊断价值

目的 研究NMO-IgG对视神经脊髓炎的诊断价值.方法 收集解放军总医院2008年11月至2009年6月住院和门诊临床诊断的患者共80例,其中视神经脊髓炎(NMO)及高危NMO(HR-NMO)患者23例,经典多发性硬化(MS)患者36例,临床孤立综合征(CIS)11例,其他神经系统疾病患者10例,采用细胞间接免疫荧光法检测所有患者血清视神经脊髓炎特异性IgG抗体(NMO-ISG)滴度水平,比较各组患者临床特点及NMO-IgG水平.结果 NMO、HR.NMO组与MS、CIS组相比,发生严重视神经炎、横贯性脊髓炎、有颅脑MRI正常表现、脊髓病灶超过3个椎体节段及血清NMO-IgG阳性均有统计学意义(P<0.05).NMO与HR-NMO组血清NMO-IgG显著高于MS组,而MS组血清NMO-IgG又略高于CIS组与其他疾病组.血清NMO-IgG诊断NMO的灵敏度达82.6%,特异性达96.2%.结论 血清NMO-IgG的检测对视神经脊髓炎的诊断及鉴别诊断有一定的价值.

Evaluation of diagnostic value for NMO-IgG in patients with neuromyelitis optica

Objective To investigate the value of NMO-IgG in the diagnosis of neuromyelitis optica (NMO). Methods A total of 80 patients with NMO, high-risk NMO (HR-NMO), multiple sclerosis(MS) ,clinical isolated syndrome (CIS) and other neurological diseases ( subacute combined degeneration,cerebral infarction, intracranial hemorrhage and neurofibroma) were included in to the study. The titers of all patients' serum NMO-IgG were detected by indirect immunofluorence. Results There were significant differences in NMO, HR-NMO MS, and CIS between patients with severe optical neuritis, transverse myelitis, normal brain MRI scan, spinal-cord lesion > 3 segments and serum NMO-IgG positive (P <0. 05). The level of serum NMO-IgG of NMO, HR-NMO was higher than that of MS, while the level of serum NMO-IgG of MS was slightly higher than that of CIS and other diseases. The sensitivity and specificity of NMO-IgG were 82.6% versus 96. 2% in the diagnosis of NMO. Conclusion NMO-IgG is valuable for diagnosing NMO and differentiating it from MS.