不同滴度MOG-IgG抗体在MOG抗体相关疾病中的诊断和临床意义:一项单中心回顾性研究  

Diagnostic value of low versus high titers of MOG-IgG and their clinical implications in myelin oligodendrocyte glycoprotein antibody-associated disease:a retrospective single center study

作　　者：李子昂 王冬梅[1] 陈金玉[1] 黄小珍 吴永明[1] 胡亚芳[1] LI Ziang;WANG Dongmei;CHEN Jinyu;HUANG Xiaozhen;WU Yongming;HU Yafang(Department of Neurology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院神经内科,广东广州510515

出　　处：《南方医科大学学报》2023年第11期1865-1873,共9页Journal of Southern Medical University

基　　金：南方医科大学南方医院院长基金(2019B007);国家自然科学基金(82201505);南方医科大学南方医院临床研究专项(2021CR020)。

摘　　要：目的总结本中心外周血髓鞘少突胶质细胞糖蛋白(MOG)抗体阳性患者的临床特征,探讨不同滴度抗体对诊断的意义。方法对2020年12月~2022年12月入院的血清MOG抗体阳性患者进行了回顾性研究。收集患者的一般人口学特征、实验室检查结果、影像学特点、治疗及预后信息。以1∶100作为分界值将患者分为高、低两个滴度组,对两组患者的特征进行对比分析。结果共纳入36例患者,其中28例被诊断为MOGAD(77.78%,低滴度15例,高滴度13例)。MOGAD的临床特征与既往研究报道基本一致,临床表现略有不同,感觉异常发生率较高(52.78%),视力丧失的比例较低(25%)。磁共振成像结果显示脑室周围白质为常见病变部位(45.71%)。高滴度组患者血清淋巴细胞水平明显降低(P=0.025),中性粒细胞与淋巴细胞比值较高(P=0.045),血清游离甲状腺素(FT4)水平较高(P=0.033),脑脊液中葡萄糖水平较高(P=0.007)。结论低滴度和高滴度的MOGIgG在MOGAD的诊断价值上相似,且不同滴度结果可能与疾病严重程度和应激水平有关。Objective To summarize the clinical characteristics of myelin oligodendrocyte glycoprotein antibody-associated disease(MOGAD)and explore the value of MOG-IgG titers for diagnosis and evaluating disease severity of MOGAD.Methods This retrospective study was conducted among the patients positive for serum MOG-IgG admitted in our hospital from December,2020 to December,2022.With 1∶100 as the cutoff value of MOG-IgG titer,the patients were divided into low and high MOG-IgG titer groups for comparison of general demographic data,laboratory test results,imaging features,treatment,and prognosis.Results Of the 36 patients included,28 were diagnosed with MOGAD(77.78%),including 15 with low and 13 with high MOG-IgG titers.Compared with the cases reported previously,the MOGAD patients included herein showed a higher prevalence of sensory abnormalities(52.78%)and a lower prevalence of vision loss(25%).Magnetic resonance imaging showed that the periventricular white matter was the most common lesion site(45.71%).The patients with high MOG IgG titers had significantly lower peripheral blood lymphocyte counts(P=0.025)with an increased neutrophil-to-lymphocyte ratio(P=0.045),higher serum free thyroxine levels(P=0.033)and higher cerebrospinal fluid glucose levels(P=0.007)as compared with those with low MOG-IgG titers.Conclusion Low titers and high titers of MOG-IgG have similar diagnostic value for MOGAD.The serum titers of MOG-IgG are probably associated with the disease severity and stress levels of the patients with MOGAD.

关 键 词：少突胶质细胞糖蛋白 核磁共振 脱髓鞘疾病 

分 类 号：R744.5[医药卫生—神经病学与精神病学]