寡克隆区带和IgG指数在多发性硬化中的诊断意义

目的研究寡克隆区带（OCBs）和IgG指数（IgGI）对多发性硬化（MS）诊断的敏感性及其影响因素。方法用等电聚焦结合银染色法检测30例MS、40例神经系统炎性疾病（NID）和22例神经系统非炎性疾病（NNID）患者CSF中OCBs，并计算IgG I。结果MS组和NID组比较OCBs阳性率、IgG I异常率均无显著性差异（P〉0．05）；MS组、NID组与NNID组比较。差异均有显著性（P〈0．05）；传统型MS和脊髓型MS比较，差异均无显著性（P〉0．05）。OCBs对MS诊断的敏感性、特异性和阳性结果似然比分别为63．3％、77．7％和2．8；IgG I分别为40．0％、76．7％和1．7。结论本地区MSOCBs阳性率和IgG I异常率较低，可能与遗传背景、疾病类型和药物应用有关，OCBs和IgG I对MS诊断具有相对特异性。

The diagnostic significance of oligoclonal bands and IgG index in multiple sclerosis

Objective To study the sensitivity of oligoclonal bands (OCBs) and IgG index (IgG I) for diagnosis of multiple sclerosis (MS) and its influent factors. Methods OCBs in the cerebrospinal fluid (CSF) from 30 patients with MS,40 with other nervous system inflammatory diseases (NID) and 22 with nervous system noninflammatory diseases (NNID) were detected using isoelectric focusing combined with silver staining,and IgG I was calculated. Results There was no significant difference in the abnormal rate of OCBs and IgG I between MS group and NID group (P>0. 05). Compared with NNID,MS and NID groups had a significantly higher incidence of OCBs and IgG I (P<0. 05). There was no significant difference in the frequency of OCBs and increased IgG I between conventional MS and spinal MS (P>0. 05). The sensitivity ,specificity and positive result likelihood ratio of OCBs were 63. 3%,77. 7% and 2. 8 respectively; those of IgG I were 40. 0% ,76. 7% and 1. 7. Conclusions As for MS, the lower frequency of OCBs and increased IgG I in our area may be related to the genetic background, the different types of MS and administration of corticosteroids. OCBs and IgG I are of relative specificity for diagnosis of MS.