多发性硬化脑脊液之特点

目的探讨多发性硬化(MS)脑脊液(CSF)的特点,为MS提供可靠的有价值的诊断资料。方法采用临床病例分析统计方法,归纳、分析51例MS患者的临床和CSF资料。结果MS的CSF外观正常;压力大多正常;白细胞数正常或轻度升高;有些CSF蛋白轻度升高,以IgG升高为主;血脑屏障(BBB)多数正常,部分被破坏;脑脊液寡克隆区带(CSF-OCB)和IgG指数(IgGI)的阳性率分别为35.3%、54.9%。国内MS患者CSF-OCB阳性率较低可能与国内视神经脊髓炎(ON)所占比率较高有关;CSF-OCB的呈现还受到MS活动性的影响,激素等免疫抑制剂的作用亦可能参与其中。结论在临床资料的基础上,再结合CSF的检查有助于MS诊断及指导临床治疗;CSF-OCB和IgGI的阳性结果(尤其是前者)对此意义更大。

Features of cerebrospinal fluid with multiple sclerosis

Objective To investigate the features of cerebrospinal fluid(CSF) with multiple sclerosis(MS) and provide a reliable and valuable information in the diagnosis of MS.Methods Clinical data of 51 CSF patients with MS was gathered for statistical analysis.Results The appearance of CSF was normal while the pressure of it was normal in most cases.White blood cell count was in normal range or lightly increased.Some of the proteins in CSF demonstrated slight increase with prominent IgG.A majority of blood brain barrier(BBB) was normal but some was destroyed.The positive rate of CSF-restricted oligoclonal bands(CSF-OCB) and that of IgG index(IgGI) were 35.3% and 54.9% respectively.The comparatively low positive rate of CSF-OCB in China may be due to the comparatively high incidence of optic neuromyelitis(ON).Also,administering immuno-depressor as corticosteroids might be responsible for the presence of CSF-OCB affected by the activity of MS.(Conclusion) It is helpful to the diagnosis of MS when the examination of CSF was combined with the clinical information.The positive results of CSF-OCB and IgG,especially the former,reveal much significance.