| 视神经脊髓炎谱系疾病与多发性硬化患者部分脑脊液免疫标志物的比较分析 |
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| 引用本文： | 视神经脊髓炎谱系疾病与多发性硬化患者部分脑脊液免疫标志物的比较分析. 视神经脊髓炎谱系疾病与多发性硬化患者部分脑脊液免疫标志物的比较分析[J]. 首都医科大学学报, 2021, 42(5): 721-725. DOI: 10.3969/j.issn.1006-7795.2021.05.005 |
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| 作者姓名： | 视神经脊髓炎谱系疾病与多发性硬化患者部分脑脊液免疫标志物的比较分析 |
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| 作者单位： | 首都医科大学宣武医院检验科,北京100053;首都医科大学医学检验技术系,北京100053 |
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| 基金项目： | 扬帆计划;重点专科建设项目 |
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| 摘 要： | 目的 观察血清、脑脊液(cerebrospinal fluid,CSF)白蛋白(albumin,ALB)、免疫球蛋白、补体水平及相关合成指标在多发性硬化(multiple sclerosis,MS)和视神经脊髓炎谱系疾病(neuromyelitis optica spectrum disorders,NMOSD)中的变化,初步分析上述指标在两种疾病诊断及鉴别诊断中的意义。方法 选取91例已确诊神经系统脱髓鞘患者,包括MS患者33例,NMOSD患者58例,选取头痛患者50例作为非炎性对照组。测定血清及CSF中ALB、IgA、IgM、IgG以及血清C3、C4等浓度,并计算血清免疫球蛋白与CSF免疫球蛋白比值IgA Q、IgG Q、IgM Q、ALB Q及与年龄相关的Reiber双曲线上部判别值(Reiber's upper hyperbolic discrimination line, Qlim)(ALB),计算ALB Q>Qlim (ALB)比例及IgG 24 h鞘内合成率,比较分析MS、NMOSD与头痛对照组间各指标差异。结果 MS和NMOSD组患者CSF IgG、IgG Q、IgG 24 h鞘内合成率和ALB Q>Qlim (ALB)比例均显著高于对照组(P<0.05),且MS组患者IgG 24 h鞘内合成率和IgG Q明显高于NMOSD组(P<0.05)。结论 MS和NMOSD均有血-脑脊液屏障功能损伤,而鞘内IgG的合成是MS和NMOSD的一个关键区分点,在两者的鉴别诊断中有重要意义。
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| 关 键 词： | 视神经脊髓炎谱系疾病 多发性硬化 血-脑脊液屏障 鞘内合成 |
| 收稿时间： | 2021-08-24 |
The comparative analysis of several biomarkers in the cerebrospinal fluid of multiple sclerosis and neuromyelitis optica spectrum disorders |
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| Shi Lili,Wang Jinling,Wang Yifei,Li Lei,Wang Peichang. The comparative analysis of several biomarkers in the cerebrospinal fluid of multiple sclerosis and neuromyelitis optica spectrum disorders[J]. Journal of Capital Medical University, 2021, 42(5): 721-725. DOI: 10.3969/j.issn.1006-7795.2021.05.005 |
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| Authors: | Shi Lili Wang Jinling Wang Yifei Li Lei Wang Peichang |
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| Affiliation: | 1. Clinical Laboratory, Xuanwu Hospital, Capital Medical University, Beijing 100053, China; 2. Department of Medical Laboratory Technology, Capital Medical University, Beijing 100053, China |
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| Abstract: | Objective To observe the changes of several biomarkers, including ALB, immunoglobulin and complements,etc, in the serum and cerebrospinal fluid(CSF) of multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD), and to explore the significance of each index in the diagnosis as well as differential diagnosis of the two diseases. Methods A total of 91 patients with central nervous system demyelinating diseases were enrolled,including 33 MS patients and 58 NMOSD patients. Fifty patients with Headache (HA) were selected as non-inflammatory control group. The blood and CSF specimen were collected. ALB, IgA, IgG, IgM in the serum and CSF as well as C3, C4 in the serum were measured. The ratio of IgA, IgG, IgM,ALB in the serum and in CSF as IgA Q, IgG Q, IgM Q,ALB Q and the index of 24 h intrathecal synthesis rate and ALB Q>Qlim (ALB) were counted. The difference of the biomarkers in MS and NMOSD patients were analyzed. Results The levels of CSF IgG, IgG Q, 24 h intrathecal synthesis rate and the ratio of ALB Q>Qlim (ALB) in MS and NMOSD group were statistically significant higher than that in control group(P<0.05). Moreover, the 24 h intrathecal synthesis rate and IgG Q of MS group were significantly higher than that of NMOSD group(P<0.05). Conclusion Both MS and NMOSD featured in the impaired blood-brain barrier function, but it could be differentiated with intrathecal IgG synthesis between MS and NMOSD. |
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| Keywords: | neuromyelitis optica spectrum disorders multiple sclerosis blood brain barrier intrathecal synthesis |
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