脑脊液寡克隆区带、24小时鞘内IgG合成率及IgG指数在脑脊膜血管型神经梅毒诊断中的应用研究  

Application of Cerebrospinal Fluid Oligoclonal Bands,24-hour Intrathecal IgG Synthesis Rate and IgG Index in the Diagnosis of Meningovascular Syphilis

作　　者：何艳群[1] 许东梅 王雅杰 李晶晶 黄宇明 HE Yan-Qun;XU Dong-Mei;WANG Ya-Jie;LI Jing-Jing;HUANG Yu-Ming(Department of Clinical laboratory,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Department of Neurology,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Department of Radiology,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院检验科,北京100015 [2]首都医科大学附属北京地坛医院神经内科 [3]首都医科大学附属北京地坛医院放射科

出　　处：《中国卒中杂志》2021年第7期675-679,共5页Chinese Journal of Stroke

基　　金：首都医科大学附属北京地坛医院院内科研基金“启航计划”项目(DTQH201402)。

摘　　要：目的探讨脑脊液寡克隆区带、24 h鞘内IgG合成率及IgG指数在脑脊膜血管型神经梅毒诊断中的应用价值。方法回顾性分析2014年6月-2019年6月于首都医科大学附属北京地坛医院神经内科连续住院的脑脊膜血管型神经梅毒患者的临床资料,对脑脊液甲苯胺红不加热血清试验(toluidineredunheated serum test,TRUST)、寡克隆区带、24 h鞘内IgG合成率及IgG指数诊断脑脊膜血管型神经梅毒的阳性率和假阴性率进行分析。结果研究共纳入确诊的脑脊膜血管型神经梅毒患者102例。脑脊液寡克隆区带、24 h鞘内IgG合成率及IgG指数检查的阳性率分别为93.1%、93.1%和91.2%,均高于TRUST检查的阳性率(71.6%,均P<0.001)。脑脊液寡克隆区带、24 h鞘内IgG合成率及IgG指数检查的假阴性率分别为6.9%、6.9%及8.8%,均低于TRUST检查(28.4%,均P<0.001)。结论脑脊液寡克隆区带、24 h鞘内IgG合成率及IgG指数均可用于脑脊膜血管型神经梅毒的诊断,且上述指标的敏感性和假阴性率均优于脑脊液TRUST检测。Objective To investigate the value of cerebrospinal fluid(CSF)oligoclonal bands,24-hour intrathecal IgG synthesis rate and IgG index in the diagnosis of meningovascular syphilis.Methods Clinical data of patients with meningovascular syphilis hospitalised in the Department of Neurology,Beijing Ditan Hospital,Capital Medical University from June 2014 to June 2019 were retrospectively analyzed,and the positive(abnormal)rate,false negative rate of CSFTRUST,oligoclonal bands,24-hour intrathecal IgG synthesis rate and IgG index in patients with meningovascular syphilis were analyzed.Results A total of 102 patients with meningovascular syphilis were enrolled.The positive(abnormal)rates of CSF oligoclonal bands,24-hour intrathecal IgG synthesis rate and IgG index were 93.1%,93.1%and 91.2%,respectively,which were all significantly higher than that of TRUST(71.6%)(all P<0.001).The false negative rates of CSF oligoclonal bands,24-hour intrathecal IgG synthesis rate and IgG index were 6.9%,6.9%and 8.8%,respectively,which were all lower than that of CSF-TRUST(28.4%)(all P<0.001).Conclusions The CSF oligoclonal bands,24-hour intrathecal IgG synthesis rate and IgG index can be used in the diagnosis of meningovascular syphilis,and the sensitivity and false negative rates of the above indexes were better than that of CSF-TRUST.

关 键 词：寡克隆区带 24小时鞘内IgG合成率 IGG指数 脑脊膜血管型神经梅毒 

分 类 号：R759.13[医药卫生—皮肤病学与性病学]