脑脊液寡克隆区带在神经系统疾病诊断中的意义

目的 :探讨脑脊液寡克隆区带 (CSF OCB)在神经系统疾患中的临床意义 ,并对多发性硬化 (MS)患者CSF OCB阳性和阴性结果进行比较研究。方法 :收集 3 98例神经系统疾患的脑脊液和血清标本 ,其中 5 1例MS患者 ,用等电聚焦加免疫标记的方法进行OCB的检测。结果 :CSF OCB阳性率在MS、神经系统炎性疾患及神经系统非炎性疾患中分别为 3 5 3 %、3 9 6%及 4 5 %。MS患者CSF OCB阳性率与临床类型、MS活动性、病程和应用激素等免疫抑制剂治疗有关。结论 :CSF OCB的检查对于MS和神经系统炎性疾患有一定的诊断价值。MS患者CSF OCB阳性率较低与国内视神经脊髓炎所占比率较高有关 ;CSF OCB的出现受到MS活动性的影响 ;也和MS病程演变阶段性相关 ;激素等免疫抑制剂的作用可能参与其中。

Clinical Significance of CSF-restricted OCB in Neurological Diseases

Aim:To investigate the clinical significance of CSF-restricted OCB in neurological disease and make a comparative study of CSF-restricted OCB positive and CSF-restricted OCB negative MS patients.Methods:In CSF and serum from 398 patients with neurological diseases ,51 of whom had MS,OCB were detected using isoelectric focusing with immunofixation.Results:In MS,neurological inflammatory diseases and non-inflammatory diseases,the positive rate of CSF-restricted OCB were 35.3%,39.6% and 4.5% respectively.In MS,the positive rate of CSF-restricted OCB correlated with disease types,duration and applying of immuno-depressor such as corticosteroids.Conclusion:The CSF-restricted OCB was helpful in the diagnosis of MS and neurological inflammatory diseases.The comparatively low positive rate of CSF-restricted OCB in China may due to the comparatively high incidence of optic neuromyelitis.Also,the presence of CSF-restricted OCB was affected by the activity of MS.Still,the effects of the evolution of disease contributed to the appearance of CSF-restricted OCB by stages,which also may due to the applying of immuno-depressor such as corticosteroids.