视神经脊髓炎IgG抗体与临床相关性研究  

Neuromyelitis optica IgG and related clinical features of patients with neuromyelitis optica

作　　者：尤小凡[2] 叶静[1] 李存江[1] 廖张元[1] 孙慧[1] 

机构地区：[1]首都医科大学宣武医院神经内科,北京100053 [2]首都医科大学附属北京朝阳医院神经内科

出　　处：《中华医学杂志》2010年第35期2477-2480,共4页National Medical Journal of China

摘　　要：目的 探讨视神经脊髓炎IgG抗体（NMO-IgG）对视神经脊髓炎和多发性硬化的鉴别诊断价值,分析NMO-IgG与视神经脊髓炎临床特点的相关性.方法 2006年12月至2008年6月收集首都医科大学宣武医院就诊的急性期视神经脊髓炎41例,多发性硬化44例和40名健康对照者,间接免疫荧光法检测血清NMO-IgG,扩展残疾状态量表评价疾病严重程度,分析NMO-IgG与视神经脊髓炎临床特点、影像学的相关性.结果 视神经脊髓炎组NMO-IgG阳性率70.7%（29/41）,多发性硬化组9.1%（4/44）和健康组0%,差异有统计学意义（P＜0.01）.NMO-IgG区分视神经脊髓炎和多发性硬化的敏感性70.7%,特异性90.9%.NMO-IgG阳性的患者疾病严重程度评分高于阴性组（P＜0.05） NMO-IgG阳性患者脊髓3个节段以上受累占93.1%,高于阴性组66.7%,但差异无统计学意义（P=0.154）.结论 NMO-IgG是视神经脊髓炎特异的生物学标记物,有助于视神经脊髓炎与多发性硬化的区分.NMO-IgG可能与疾病严重程度有关.Objective To investigate the differential diagnostic value of NMO-IgG for neuromyelitis optica （NMO） versus multiple sclerosis （MS） and to analyze its possible clinical features related to NMOIgG. Methods Forty-one NMO patients and 44 MS patients in acute phase and 40 healthy controls were investigated. Serum NMO-lgG was tested by indirect immunofluorescence assay. The disability severity in NMO and MS patients was assessed by Expanded Disability Status Scale （EDSS）. Clinical features and MRI imaging profiles were analyzed between NMO-IgG positive patients and negative ones. Results 70. 7% （29/41 ） NMO patients were NMO-IgG positive compared to 9. 1% （4/44） MS patients and all healthy controls were NMO-IgG negative （P 〈 0. 01 ）. The sensitivity and specificity were 70. 7% and 90. 9% respectively when NMO-IgG was used to discriminate NMO from MS. NMO patients with positive NMO-IgG had significantly higher EDSS scores （ P 〈 0. 05 ） . More NMO-IgG seropositive patients had longitudinally extensive cord lesions （ ≥3 segments） than the NMO-IgG seronegative patients （93. 1% vs 66. 7% ）. But the difference was insignificant. Conclusion NMO-IgG is a specific biomarker of NMO. NMO-IgG can facilitate an early differentiation of NMO from MS. NMO-IgG seropositivity is related to graver symptoms and it may predict an aggravation.

关 键 词：视神经脊髓炎 多发性硬化 免疫球蛋白G 荧光抗体技术 间接 

分 类 号：R744.52[医药卫生—神经病学与精神病学]