多发性硬化和其他神经系统疾病脑脊液寡克隆区带的初步观察

作者用聚丙烯酰胺凝胶电泳法对165例神经系统疾病患者进行了脑脊液的寡克隆区带(O-B)检测,观察到多发性硬化及散发性脑炎患者的O-B检出率较高,非炎性神经系统疾病患者仅少数出现O-B。本法取材少,脑脊液不需浓缩,方法简便,检出率高,适合临床应用。

OLIGOCLONAL IMMUNOGLOBULIN BAND IN CEREBROSPINAL FLUID IN MULTIPLE SCLEROSIS AND OTHER NEUROLOGICAL DISEASE

This paper reports the oligoclonal Igbands (O-B) in the polyacrylamide gelelectrophoresis of unconcentrated CSF from165 cases with multiple sclerosis (MS)and other neurological disease (OND).The control CSF specimens collectedfrom 20 cases with osteoarthropathydisease were obtained when anesthesiawas performed by lumbar puncture.Inthe laboratory assay a modification ofThompson's methoed was used withnaphthol black staining.The presence oftwo or more homogeneous bands andtwo or more discrete peaks in thegamma area constituting an O-B wasvisible to the naked eye and on thescanning graphy. The O-B was found in 71% of 100cases with MS including 71.2% of theclinically definite MS cases,75% of theprobable MS casas and 60% of the possibleMS cases.O-B was found in OND,namely in encephalitis,69% of 26 cases,Guillain--Barre symdrome,85.5% of 8cases.Three cases with spinal arach-noiditis and 2 cases with metastaticbrain tumors hed an O-B.In nonin-flammatory diseases the O-B was foundonly in 3 of 26 cases.The three caseswere basilar impression,chronic subduralhemorrhage and cerebral atrophy.Allof 20 cases for control did not havean O-B. Although the O-B pattern is notspecific for MS found in OND.It isusually not difficult to distinguish be-tween MS and the OND on the clinicalground and laboratory criteria Our patients with MS were found tohave a high percentage of the appear-ance of O-B in the age range of41-50, in the early course and atthe active stage of the disease.66.9% of71 MS cases with normal TP con-centration in CST had O-B and 61.5%of 26 MS cases with normal IgG levelhad O-B.Two patients continued to haveO-B,after the steroid therapy,for 3to 6 months.As the percentage ofthe appearence of O-B in MS patientsis high and the experiment is sensitive,the O-B pattern provides an importantsupportive evidence for the diagnosis ofMS.