血清抗髓鞘少突胶质细胞糖蛋白抗体对多发性硬化的诊断意义  

Serum levels of anti-myelin oligodendrocyte glycoprotein antibody in diagnosis of multiple sclerosis

作　　者：厉向[1] 夏君慧[1] 张旭[1] 

机构地区：[1]温州医科大学附属第一医院神经内科,325000

出　　处：《浙江医学》2013年第20期1795-1798,1801,共5页Zhejiang Medical Journal

基　　金：温州市科技局基金资助项目(Y20080094;Y20090004;Y20100275)

摘　　要：目的探讨血清抗髓鞘少突胶质细胞糖蛋白(MOG)抗体对多发性硬化(MS)的诊断意义。方法 利用放射免疫方法分别测定23例MS、57例临床孤立综合征(CIS)、41例其他炎症性神经系统疾病(OIND)、37例非炎症性神经系统疾病(ONND)患者的血清抗MOG抗体水平。并对MRI发现中枢神经脱髓鞘患者的病灶负荷进行测定,将其与患者血清中抗MOG抗体水平作相关性分析。通过绘制受试者受试者工作特征(ROC)曲线,比较血清抗MOG抗体水平、脑脊液IgG指数、24h鞘内IgG合成率等参数对MS诊断的敏感性和特异性。结果 MS组患者血清中抗MOG抗体的水平及抗MOG抗体阳性率明显高于CIS组、OIND组和ONND组,差异有统计学意义(P<0.01)。MS组活动期血清抗MOG抗体的水平及阳性率高于缓解期(P<0.05)。中枢脱髓鞘病变(MS和CIS)患者MRI显示的病灶负荷与其血清抗MOG抗体水平呈正相关(P<0.01)。抗MOG抗体的ROC曲线下面积,高于脑脊液IgG指数、24h鞘内IgG合成率。结论血清抗MOG抗体可以成为可靠的诊断MS的生物学指标之一。Objective To assess serum levels of anti- myelin oligodendrocyte glycoprotein （MOG） antibody in diagnosis of multiple sclerosis（MS）. Methods The serum levels of anti- MOG antibody were detected with radioimmunoassay（RIA） in 23 pa-tients with MS, 57 patients with clinical y isolated syndrome（CIS）, 41 patients with other inflammatory neurological diseases（OIND） and 37 patients with other non- inflammatory neurological diseases （ONND）. The burden of disease （BOD） in patients with central nervous system demyelinating diseases was assessed by T2- weighted MRI and the relationship between anti- MOG antibody level and BOD was analyzed. The sensitivity and specificity of serum anti- MOG antibody, CSF IgG index, IgG 24- h synthesis rate for diagnosis of MS were evaluated with receiver operating characteristic curve （ROC）. Results The serum levels of anti- MOG antibody and positive rate in MS group were significantly higher than those in CIS group, OIND group and ONND group （P〈0.01）. The serum levels and positive rate of anti- MOG antibody in MS patients were correlated with disease activity （P〈0.05）. The serum levels of anti- MOG antibodies were correlated with BOD in patients with demyelinating disease （MS and CIS group）（P〈0.01）. In ROC curve the area under the curve （AUC） of anti- MOG antibody was larger than that of CSF IgG index and 24- h IgG synthesis rate. Conclusion The serum levels of anti MOG antibody can be used as a reliable biomarker for diagnosis of MS.

关 键 词：髓鞘少突胶质细胞糖蛋白自身抗体 多发性硬化 放射免疫分析 受试者工作特征曲线 病灶负荷 

分 类 号：R744.51[医药卫生—神经病学与精神病学]