IgG及IgG指数在中枢神经系统疾病中的诊断价值

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。

Diagnostic value of Changes of IgG and IgG index in central nervous system disease

Objective To investigate the clinical significance of IgG and IgG index in the diagnosis of central nervous system disease. Methods 104 cases of matched samples of cerebrospinal fluid （CSF） and sera were collected from 77 patients with central nervous system disease （divided into purulent meningitis group, tuberculous meningitis group, viral meningitis group, multiple sclerosis group, and Guillain-Barre syndrome group） and 27 healthy controls （healthy control group）. The CSF albumin and IgG （CIgG） and serum IgG were measured by applying BNP specific protein analyzer with immunonephelometry （INA） method. The serum albumin was measured by applying OLYM- PUS2700 automatic biochemical analyzer with bromocresol green method. The ratio of CSF albumin to serum albumin （QALB） and IgG index were calculated. Results QALB and CIgG were markedly higher in purulent meningitis group and tuberculous meningitis group than those in healthy control group （P〈0.05）, but IgG index wasnrt significantly different （P〉0.05）. QALB, CIgG and IgG were all evidently higher in viral meningitis group than those in healthy control group （P〈0.05）. In multiple sclerosis group, QALB didn＇t increase significantly, but CIgG and IgG index were markedly higher than those in healthy control group （P〈 0. 05）. Compared with healthy control group, Guillain-Barre syndrome group had significantly higher QALB and CIgG and normal IgG index. Conclusion The measurements of QALB, CIgG and IgG index are helpful to learn about degree of blood brain barrier damage and source of CSF IgG, which contributes to diagnosis, treatment and prognosis evaluation of central nervous system diseases.