副肿瘤特征性抗体阳性患者脑脊液结果分析及意义  

Cerebrospinal fluid study in patients with well characterized onconeural antibodies

作　　者：邵春青[1] 张冬琬 吕虹[1] 卜颖[1] 王毅娟[1] 杨薇[1] 张国军[1] SHAO Chunqing;ZHANG Dongwan;LYU Hong;BU Ying;WANG Yijuan;YANG Wei;ZHANG Guojun(不详;Department of Clinical Laboratory,Beijing Tiantan Hospital,Capital Medical University/Beijing Engineering Research Center of Immunological Reagents Clinical Research,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院检验科,北京市免疫试剂临床工程技术研究中心,100070 [2]首都医科大学临床检验诊断学系,100070

出　　处：《中国神经免疫学和神经病学杂志》2021年第5期392-396,共5页Chinese Journal of Neuroimmunology and Neurology

基　　金：北京市医管中心“扬帆计划”项目(ZYLX202108)。

摘　　要：目的探讨副肿瘤特征性抗体阳性患者脑脊液(CSF)特征及其在辅助诊断中的价值。方法回顾性分析北京天坛医院实验诊断中心检测的118例副肿瘤特征性抗体阳性患者的临床资料及实验室数据。根据抗体浓度将患者分为抗体弱阳性(79例)、阳性(23例)和强阳性组(16例),根据CSF抗体情况将患者分为CSF抗体阳性组(22例)和阴性组(87例),根据病程将患者分为病程≤3个月组(76例)和病程>3个月组(42例)。分析各组间年龄以及CSF白细胞计数、总蛋白、IgG指数、24 h IgG鞘内合成率、寡克隆区带(CSF-OCB)和白蛋白商(QAlb)间的差异。结果(1)抗体强阳性组CSF-OCB阳性率和QAlb异常率高于阳性组和弱阳性组(P<0.05)。(2)CSF抗体阳性组CSF白细胞、总蛋白、IgG指数、24 h IgG鞘内合成率和QAlb异常率均高于CSF抗体阴性组(P<0.05)。(3)病程≤3个月组CSF白细胞高于病程>3个月组(P<0.01)。结论副肿瘤特征性抗体阳性患者存在中枢神经系统炎性反应,其发病与体液免疫相关,病程早期CSF白细胞计数增高明显,研究CSF相关指标有助于全面了解患者免疫状况。Objective To investigate the characteristics of cerebrospinal fluid(CSF)tests in patients with well characterized onconeural antibodies and its value in auxiliary diagnosis.Methods The clinical and laboratory data of 118 patients with well characterized onconeural antibodies were analyzed retrospectively.According to the antibody concentrations,the patients were divided into a weak positive group(79 cases),a positive group(23 cases),and a strong positive group(16 cases).The patients were divided into a CSF antibody positive group(22 cases)and a CSF antibody negative group(87 cases)by the CSF antibody status.According to the disease course,the patients were divided into a course≤3 months group(76 cases)and a course>3 months group(42 cases).Age,CSF white blood cell(CSF-WBC)count,total protein,IgG index,24 h IgG intrathecal synthesis rate,oligoclonal bands(CSF-OCB),and albumin quotient(QAlb)among groups were analyzed.Results(1)The positive rate of CSF-OCB and abnormal rate of QAlb in the strong positive group were significantly higher than those in the positive and weak positive groups(P<0.05).(2)CSF-WBC,total protein,IgG index,24 h IgG intrathecal synthesis rate,and QAlb abnormal rate in the CSF antibody positive group were significantly higher than those in the negative group(P<0.05).(3)The CSF-WBC in the course≤3 months group was significantly higher than that in the course>3 months group(P<0.01).Conclusions Patients with well characterized onconeural antibodies have central nervous system inflammatory reaction,the onset of which is related to humoral immunity,the CSF-WBC count increased significantly in the early stage of the disease.The CSF tests are helpful to understand the immune status of patients with well characterized onconeural antibodies.

关 键 词：副肿瘤特征性抗体 副肿瘤综合征 神经系统 边缘叶脑炎 寡克隆区带 白细胞 白蛋白商值 24h IgG合成率 

分 类 号：R747.9[医药卫生—神经病学与精神病学]