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1.
脑脊液寡克隆区带检测在神经系统疾病诊断中的意义——附136例报告 总被引:1,自引:2,他引:1
目的:探讨检测脑脊液寡克隆区带(oligoclonal bands,OCB)在神经系统疾病,尤其是多发性硬化诊断中的临床意义。方法:136例神经系统疾病患者分为4组,其中多发性硬化患者32例为多发性硬化组,余下患者分为中枢神经系统感染性疾病组(42例),中枢神经系统非感染性疾病组(40例),外周神经系统疾病组(22例):应用等电聚焦加抗生物素-生物素-过氧化酶复合物技术检测136例神经系统疾病患者脑脊液OCB,并进行对比分析。结果:①多发性硬化组OCB阳性率为37%,中枢神经系统感染组为24%,中枢神经系统非感染性疾病组为5%,外周神经系统疾病组为0;多发性硬化组的OCB阳性率比其他各组高,但低于国外报道的阳性率;②多发性硬化患者中传统型多发性硬化组OCB阳性率为56%,高于视神经脊髓炎组的11%:结论:中国多发性硬化患者OCB阳性率不高,提示有必要寻找更加敏感的诊断指标。 相似文献
2.
目的探讨血清降钙素原(PCT)与C-反应蛋白(CRP)在儿童细菌感染性疾病中得诊断价值。方法随机统计本院儿童患者131例,按临床诊断分为细菌性感染组和非细菌性感染组。检测PCT和CRP在两组中所占阳性率统计分析。结果细菌性感染组PCT阳性率为90.2%,CRP阳性率为80.5%;非细菌性感染组PCT阳性率为21.1%,CRP阳性率为65.6%。两组比较,PCT差异有统计学意义(P〈0.01),CRP差异无统计学意义(P〉0.05)。结论 PCT检测是诊断儿童细菌性感染疾病的可靠实验室指标。 相似文献
3.
儿童过敏性紫癜患者食物特异性IgG抗体检测分析 总被引:2,自引:0,他引:2
目的探讨食物特异性IgG抗体与儿童过敏性紫癜的相关性。方法采用ELISA方法检测209例儿童过敏性紫癜患者血清中13种食物特异性IgG抗体。结果 209例过敏性紫癜患儿中有139例检测到1-13种食物特异性IgG阳性升高,总阳性率为66.5%(139/209);特异性IgG阳性率较高(10%以上)的主要致敏食物有2种,分别为鸡蛋(39.2%)和牛奶(38.8%);食物特异性IgG浓度分级结果表明,鸡蛋和牛奶均可引起不同程度的食物不耐受,而其余多数食物则以引起轻度不耐受(即IgG浓度为+1级)为主。统计学分析表明:不同性别患儿食物特异性IgG阳性率无显著性差异(P〉0.05);7岁以下年龄组患儿食物特异性IgG总阳性率(77.9%)显著高于7-14岁年龄组患儿阳性率(59.8%,P〈0.05);汉族和少数民族两组患儿食物特异性IgG总阳性率无显著性差异(P〉0.05),但单种食物IgG阳性率比较发现,汉族患儿鸡蛋特异性IgG阳性率显著高于少数民族患儿(P〈0.05),少数民族患儿鳕鱼特异性IgG阳性率显著高于汉族(P〈0.05)。结论食物特异性IgG抗体与过敏性紫癜具有密切相关性,食物特异性IgG抗体检测对过敏性紫癜病因诊断将具有重要意义。 相似文献
4.
目的探讨血清降钙素原(PCT)测定对诊断儿童感染性疾病中的临床意义。方法将住院的137例患儿分成细菌感染、病毒感染和非感染3组,进行血清降钙素原(PCT)、C反应蛋白(CRP)的水平测定,并对结果进行比较。结果以PCT≥0.5ng/ml、CRP≥5.2mg/L为阳性,细菌感染组PCT阳性率为78.18%,病毒感染组PCT阳性率为7.50%,非感染组PCT阳性率为9.52%,细菌感染组与病毒感染组、非感染组两相比较有显著差异(P〈0.01);而病毒感染组与非感染组比较无差异(P〉0.05)。细菌感染组CRP阳性率为29.09%,与PCT比较,PCT阳性率明显高于CRP,具有显著差异(P〈0.01)。结论血清PCT可作为儿童感染性疾病的鉴别诊断与早期检测指标,其诊断价值优于CRP,动态检测PCT可判断疗效及指导临床用药。 相似文献
5.
末梢血CRP和WBC检测在儿科感染性疾病中的应用 总被引:2,自引:0,他引:2
目的:探讨末梢血C-反应蛋白(CRP)、白细胞计数(WBC)检测在儿科感染性疾病中的应用价值。方法:儿科275例感染性疾病患儿分别测定末梢血CRP和WBC计数,以50例健康体检儿童为对照。结果:细菌感染组CRP、WBC计数均明显升高,与正常对照组比较,差异均有统计学意义(P〈0.05);病毒性感染组CRP、WBC计数与正常对照组差异均无统计学意义(P〉0.05)。细菌性感染组CRP、WBC计数阳性率与病毒感染组和正常对照组阳性率比较,差异均有统计学意义(P〈0.05);病毒感染组CRP、WBC计数阳性率与正常对照组阳性率无统计学意义(P〉0.05)。结论:末梢血检测CRP、WBC计数联合检测有助于儿科感染性疾病的快速诊断。 相似文献
6.
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。 相似文献
7.
目的探讨中国成年人慢性丙型肝炎(chronic hepatitis C,CHC)患者发生代谢综合征(metabolicsyndrome,MS)的危险因素。方法未经治疗的80例CHC患者,分为合并MS组9例与未合并MS组71例,比较2组HCV-RNA水平和基因分型、肝脏炎症程度及生化指标。结果 MS的发生率为11.25%(9/80);2组胰岛素、胰高血糖素、胰岛素抵抗指数、瘦素、脂联素、HCV-RNA水平、肝脏炎症程度差异均无统计学意义(P〉0.05);合并MS组总胆固醇、低密度脂蛋白胆固醇、载脂蛋白B、三酰甘油、体质量指数、空腹血糖均明显高于未合并MS组(P〈0.05);多元回归分析显示体质量指数、三酰甘油是CHC患者发生MS的独立危险因素;基因1型MS发生率为8.5%,非基因1型MS发生率为11.1%,其差异无统计学意义(P〉0.05)。结论 CHC患者合并MS与体质量指数和三酰甘油密切相关,与丙型肝炎病毒本身、肝脏炎症程度及瘦素、脂联素水平无明显相关。 相似文献
8.
沈阳地区2010年6243例成人肺炎支原体抗体检测结果分析 总被引:1,自引:0,他引:1
[目的]了解沈阳地区2010年成人呼吸道感染患者肺炎支原体抗体检出的阳性比例及肺炎支原体感染与年龄、性别和季节的关系.[方法]采用被动凝集法和金标免疫斑点法检测本院2010年全年≥15岁6 243例呼吸道感染患者血清肺炎支原体抗体IgM和IgG,并对检测结果进行分析.[结果]6 243例患者中肺炎支原体抗体检出的总阳性率为14.3%(892例);IgM和IgG的阳性率分别为13.63%(851例)和3.9%(245例),男女阳性率IgM和IgG分别为10.8%、16.1%和3.6%、4.2%,性别间IgM阳性率相比较有显著性差异(P〈0.01)、而IgG比较无显著差异(P〉0.05);2010年沈阳地区全年均有肺炎支原体感染,以秋冬两季为高.随着年龄的增加,阳性率逐渐下降,以15~20岁IgM抗体的阳性检出率最高,为30.8%.[结论]沈阳地区成人肺炎支原体感染以秋冬季和15~20岁为多发,发病率女性大于男性.同时检测支原体抗体IgM和IgG对判断急性感染和了解其流行病学特点有帮助,对临床诊断和治疗有重要意义 相似文献
9.
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。 相似文献
10.
目的:探讨血常规白细胞计数与hs-CRP联合检测在诊断儿科感染性疾病中的应用价值。方法:选取2013年7月-2013年12月我院儿科门诊收治的呼吸道感染患儿141例(细菌感染患者61例,病毒感染患者80例)以及同期健康体检患儿50例作为研究对象,均在我科取末梢全血进行血常规和hs-CRP检测,分析比较三组受试者血常规WBC计数和hs-CRP水平差异。结果:细菌感染组WBC和hs-CRP平均水平均高于病毒感染组、健康对照组(P〈0.01);病毒感染组hs-CRP水平高于健康对照组(P〈0.05),但WBC计数与健康对照组比较无明显差异(P〉0.05);细菌感染组中WBC和hs-CRP双阳性率明显高于病毒感染组(P〈0.01);细菌感染组单hs-CRP阳性率高于病毒感染组(P〈0.05)。结论:联合检测hs-CRP、血常规WBC计数对小儿感染性疾病有重要诊断价值,对于小儿细菌性感染疾病有较高诊断敏感性。 相似文献
11.
Evaluation of Cobas 8000® for the quantification of albumin and IgG in serum and cerebrospinal fluid
According to the 2017 revised McDonald criteria, the presence of oligoclonal bands (OCB) at isoelectric focusing (IEF) is useful for the diagnosis of Multiple Sclerosis (MS), including relapsing-remitting MS and primary progressive MS. In this context, the quantification of IgG in serum and CSF is required for IEF execution (to deposit the same amount of IgG in serum and CSF), while the quantification of albumin in serum and CSF allows the calculation of the albumin quotient.We have evaluated the analytical performances of Cobas 8000® analyzer for the quantification of albumin and IgG in serum and CSF. Coefficients of variation were below 3.3% for within-run precision and below 3.1% for between-run precision. Results were similar or better than those obtained on nephelometer Immage 800® and turbidimeter SPAPLUS®. The uncertainty of quantification of IgG in CSF was 9% and that of albumin in CSF was 12%. IgG and albumin measured on Cobas 8000® in serum and CSF showed good agreement with results obtained on the nephelometer Immage 800®, including for the classification of albumin quotient and CSF IgG index as normal or pathological. Therefore, Cobas 8000® is a valuable tool for the quantification of IgG and albumin in CSF, in the context of diagnosis of MS and other inflammatory disease affecting the central nervous system. 相似文献
12.
小儿单纯疱疹病毒脑炎的临床分析 总被引:2,自引:0,他引:2
目的;通过分子生物学方法了解小儿中枢神经系统单纯疱疹病毒(HSv)感染情况,分析其临床特点。方法:收集150例住院的中枢神经系统病毒感染患儿的脑脊液标本,用套式PCR检测脑脊液中HSV DNA用酶联免疫吸附法检测脑脊液中特异性HSV IgM抗体。结果:150例中有6例脑脊液HSV1 DNA(+),另1例HSV1 IgM(+);病例呈散发性起病,无明显季节、年龄、性别分布特点。与其他病毒感染相比,惊厥持续状态、精神症状发生率高(P〈0.01),意识障碍、病死率无显著差异。结论:单纯疱疹病毒感染占儿童中枢神经系统感染的4.67%。儿童中枢神经系统单纯疱疹病毒感染多为HSVl的原发感染,可导致脑炎、脑干脑炎、急性播散性脊髓膜炎;起病较危重,出现精神症状较多,及时有效的抗病毒治疗能明显改善病情,降低病死率。 相似文献
13.
目的探讨IgG和IgG指数变化在中枢神经系统疾病中的诊断意义。方法收集77例中枢神经系统疾病患者和27例健康对照组的血清/脑脊液配对标本,用BNP特种蛋白分析仪,采用免疫散射比浊法分别测定脑脊液清蛋白(CALB)、脑脊液IgG(CIgG)、血清IgG(SIgG),用0LYMPUS2700全自动生化分析仪采用溴甲酚绿法测定血清清蛋白(SALB),将其结果套入相应公式换算CALB/SALB的比值(QALB)及IgG指数。结果化脓性脑膜炎与结核性脑膜炎组QALB、CIgG均明显增高与健康对照组差异有统计学意义(P〈0.05),IgG指数与健康对照组差异无统计学意义(P〉0.05);病毒性脑膜炎组QALB、CIgG、IgG指数均增高与健康对照组差异有统计学意义(P〈0.05);多发性硬化组QALB无明显增高,与健康对照组差异无统计学意义(P〉0.05),而CIgG、IgG指数明显增高,与健康对照组的差异有统计学意义(P〈0.05);格林-巴利综合征QALB、CIgG均明显增高,与健康对照组差异有统计学意义(P〈0.05),IgG指数与健康对照组差异无统计学意义(P〉0.05)。结论QALB、CIgG及IgG指数可以了解血脑屏障损伤程度及脑脊液中IgG的来源,对中枢神经系统疾病诊断、治疗及预后具有重要意义。 相似文献
14.
P D Mehta 《Critical reviews in clinical laboratory sciences》1991,28(3):233-251
Multiple sclerosis (MS) is one of the most common demyelinating diseases of the central nervous system affecting adults between the ages of 20 and 40 years. Clinically, it is characterized by episodes of exacerbations and remissions. Although the cause of MS is unknown, it is generally believed that one or more infectious agents triggers an autoimmune response that causes myelin destruction. There is no known cure for this disease; however, early diagnosis is helpful in the management of patients with MS. The diagnosis of MS is commonly made on the basis of established clinical criteria. No specific laboratory diagnostic test exists, but detection of abnormalities in cerebrospinal fluid (CSF) is a useful aid to support the clinical diagnosis of MS. This review describes the most common CSF abnormalities. These include (a) elevation of immunoglobulin G (IgG), IgG index and IgG synthesis rate; and (b) detection of oligoclonal IgG bands in the CSF by electrophoresis and isoelectric-focusing procedures. 相似文献
15.
目的探讨神经梅毒患者血清及脑脊液免疫学诊断特点。 方法选取2013年6月至2016年7月首都医科大学附属宣武医院收治的35例神经梅毒患者,其中32例患者行血清与脑脊液免疫学指标检测,回顾性分析35例患者的检查结果,应用Fisher精确检验比较血清组与脑脊液组IgA、IgM的差异,应用卡方检验比较血清组与脑脊液组IgG的差异,并对脑脊液寡克隆条带阳性检出率和脑脊液24 h IgG合成率进行分析。 结果32例神经梅毒患者检测血清免疫球蛋白,有53.13%(17/32)的患者IgG升高,6.25%(2/32)的患者IgA升高,0%(0/32)的患者IgM升高;脑脊液中,有84.38%(27/32)的患者IgG升高,100.00%(32/32)的患者IgA升高,90.63%(29/32)的患者IgM升高;血清与脑脊液IgA、IgM升高率比较,差异有统计学意义(P<0.01),IgG升高率比较,差异无统计学意义(χ2=7.27,P>0.05)。25例神经梅毒患者行CSF寡克隆电泳,IgG寡克隆条带阳性率为100.00%(25/25),96.00%(24/25)患者脑脊液24 h IgG合成率升高。 结论神经梅毒临床表现多样,是易误诊的可治性疾病。血清及脑脊液IgG多表现为升高,脑脊液IgA、IgM多表现为升高而血清IgA、IgM多表现为正常,脑脊液寡克隆条带阳性,脑脊液24 h IgG合成率升高等免疫学特点对神经梅毒诊断有意义。 相似文献
16.
Stylianos Chatzipanagiotou Constantinos Tsakanikas Maria Anagnostouli Michalis Rentzos Anastassios Ioannidis Chryssoula Nicolaou 《Molecular diagnosis》2003,7(1):41-43
BACKGROUND: During the course of multiple sclerosis (MS) intrathecal oligoclonal IgGs are present in the cerebrospinal fluid (CSF). The intracellular human pathogen Chlamydia pneumoniae may play a role either as a causative pathogenetic agent in the disease, or C. pneumoniae-infected MS patients could be immunologically less able to clear the agent from the central nervous system (CNS). METHODS: CSF samples were studied in 100 individuals -- 70 MS patients and 30 age-matched controls with other neurological diseases. CSF was taken by lumbal puncture; cell cultures were performed by the cell vial technique, followed by a 4-day incubation at 37 degrees C. A nested PCR was performed. RESULTS: C. pneumoniae was detectable in the CSF of only 2.9% of the MS patients and none of control patients (with no significant difference between the MS patients and controls). IgG antibodies were positive in only 1.43% of the MS patients and 3.33% of the controls. IgA antibodies were positive in 6.66% of the control patients and none of the patients were positive for IgM antibodies. There was no statistically significant difference between the two groups of patients with respect to the three antibody classes. CONCLUSIONS: The results confirm the high leave of controversy surrounding a possible link between C. pneumoniae and MS, and the matter requires further thorough investigation. 相似文献
17.
目的 探讨多发性硬化(MS)患者抗髓鞘碱性蛋白(MBP)抗体的临床意义。方法 采用ELISA方法测定56例多发性硬化患者急性期血清抗髓鞘碱性蛋白抗体,与30例其他神经疾病((3ND)患者及36例正常人(NC)作对照。结果 MS患者血清抗MBP抗体阳性率为78.6%,OND组抗MBP抗体阳性率为50%,与NC组比较均有显著性差异;MS患者与OND组患者抗MBP抗体阳性率比较亦有显著性差异。结论 检测血清中抗MBP抗体,可为临床诊断和治疗多发性硬化提供指导。 相似文献
18.
目的:明确检测血清S100B蛋白联合降钙素原是否在初筛中枢神经系统感染中具有重要临床价值。方法:以我院急诊抢救室及急诊留院观察疑似中枢神经系统感染的159例患者为研究对象,按患者入院时采集基本信息及血液标本并行腰椎穿刺术进行相关的检查检验。将患者按是否存在中枢神经系统感染分为中枢神经系统感染组(CNS+组)、无中枢神经系统感染组(CNS-组),分析各组患者血清PCT、S100B蛋白浓度,评价PCT联合S100B蛋白在初筛中枢神经系统感染的应用价值。结果:CNS+组患者血清PCT的浓度高于CNS-组,CNS+组患者血清S100B蛋白的浓度明显高于CNS-组。在PCT初筛阳性患者中有50%患者为中枢神经系统感染感染,而在S100B初筛阳性患者中有91.4%的患者存在中枢神经系统感染,而在PCT和S100B初筛阳性的患者全部存在中枢神经系统感染,在PCT和S100B初筛阴性的患者有45.3%存在中枢神经系统感染。结论:检测血清PCT和S100B浓度可以提高中枢神经系统感染的诊断能力。 相似文献
19.
An improved formula for the judgement of intrathecally produced IgG in the presence of blood brain barrier damage 总被引:1,自引:0,他引:1
S Ohman P Forsberg N Nelson M Vrethem 《Clinica chimica acta; international journal of clinical chemistry》1989,181(3):265-272
In order to develop a better formula for discrimination between transsudated and intrathecally produced IgG, we studied the relation between cerebrospinal fluid (CSF) IgG, serum IgG, CSF albumin, and serum albumin for patients with blood brain barrier (BBB) damage. From this study we derived a new formula, IgG extended index = (CSF IgG/serum IgG)/(CSF albumin/serum albumin). Applying this index on 152 patients with BBB damage, but not expected intrathecal IgG synthesis, yielded 14 patients (9.2%) with increased (greater than 1.24) IgG extended index. In comparison, 'conventional' IgG index was increased in 34 of the patients (22%). The diagnostic sensitivity for 68 patients with multiple sclerosis (MS), did not differ significantly between the two formulas (81 and 87%, respectively). A formula for the estimation of 24 hours IgG production was also developed, but this formula was not better than IgG index. Children (0.5-16 yr) had similar IgG patterns as adults. 相似文献
20.
Changes in cerebrospinal fluid IgG and apolipoprotein E indices in patients with multiple sclerosis during demyelination and remyelination 总被引:1,自引:0,他引:1
Approximately 85% of patients with multiple sclerosis (MS) can be diagnosed by using magnetic resonance imaging and laboratory tests such as determination of the cerebrospinal fluid (CSF) IgG Index and electrophoresis to detect oligoclonal banding. However, these tests results are abnormal in MS patients whether they are in clinical remission or acute exacerbation. Because apolipoprotein E (apo E) is synthesized in the central and peripheral nervous system, particularly during remyelination, we propose that apo E might be a reliable marker of the remyelination that accompanies clinical remission in MS patients. We studied 33 patients with MS, 22 in remission and 11 in exacerbation, and 26 controls of comparable ages. The apo E Index, calculated from the concentrations of apo E and albumin in CSF and serum, allowed us to discriminate between MS patients in remission and MS patients in exacerbation (P less than 0.001); the IgG Index failed to show similar differences. However, combining the apo E and IgG indices gave maximum discrimination between controls, MS patients in remission, and those in exacerbation. This study suggests that apo E measurements should be included in the laboratory evaluation of MS patients. 相似文献