视神经脊髓炎与多发性硬化的临床表现和视神经脊髓炎IgG抗体阳性率的对比

目的 比较视神经脊髓炎(NMO)和多发性硬化(MS)在临床表现、辅助检查等方面的不同;比较NMO和MS等脱髓鞘疾病患者血清NMO-IgG抗体的阳性率,判断该抗体能否作为鉴别诊断的一项实验室依据.方法 对34例NMO、22例MS、24例高危综合征、5例临床孤立综合征以及35例其他神经科疾病患者进行NMO-IgG检测,并对其中NMO、MS患者的人口学、临床表现、免疫学指标、脑脊液、头颅MRI等资料进行对比.结果 NMO的起病年龄较MS大且年龄跨度更广;从年复发率和进展指数来看,NMO更为严重,预后更差;NMO长节段脊髓损害者比MS多.NMO-IgG在NMO组和高危综合征组的阳性率分别为58.8%(20/34)和45.8%(11/24),高于MS组(1/22)、临床孤立综合征组(1/5)和其他疾病组(1/35;X2=37.2,P<0.01).NMO-IgG阳性率与脊髓病变长度相关.结论 NMO和MS在临床表现、辅助检查等方面都有所不同,提示NMO与MS可能是2种不同的疾病.NMO-IgG在NMO患者中的阳性率高于MS患者,可以作为鉴别诊断的一项实验室依据.

Comparison on the clinic features and neuromyelitis optica-IgG positive rate of neuromyelitis optica and multiple sclerosis

Objective To compare the clinic features of neuromyelitis optica (NMO) and multiple sclerosis(MS).To compare the positive rate of NMO-IgG in NMO,MS and other related diseases,and determine whether it can be considered as a biomarker for differential diagnosis.Methods Detected serum NMO-IgG in 34 NMO patients,22 MS patients,24 high risk syndrome,5 clinical isolated syndrome,and 35 patients with other neumlogical diseases.Compared the clinic features(onset age,severity,prognosis,MRI lesions,autoimmune antibodies,CSF)of 34 NMO patients and 22 MS patients.Results The onset age of NMO is older than that of MS.It is more severe and with worse prognosis than MS.Longitudinal spinal cord lesions are easily found in NMO.NMO-IgG positive rate in NMO and high risk syndrome patients are 58.8% (20/34)and 45.8%(11/24)respectively,which are higher than that in MS(1/22),clinical isolated syndrome(1/5)and other neurological diseases(1/35;x2=37.2,P<0.01).The positive rate may have a relationship with the length of spinal cord lesions.Condusions MS and NMO are probably different diseases.NMO-IgG positive rate in NMO is significandy higher than that in MS,it can be considered as a biomarker for differential diagnosis.