CIDP患者血清和脑脊液中硫脂抗体、P2蛋白抗体的临床意义  

Antibody to Sulfatide and P2 myelin proteins in chronic inflammatory demyelinating polyradiculoneuropathy

作　　者：吴德云[1] 李晓光[2] 郭玉璞[2] 陈琳[2] 李存江[3] 

机构地区：[1]胜利石油管理局中心医院神经科,山东东营257034 [2]北京协和医院神经科,北京100730 [3]北京宣武医院神经科,北京100710

出　　处：《中风与神经疾病杂志》2003年第3期225-227,共3页Journal of Apoplexy and Nervous Diseases

摘　　要：目的　通过测定慢性炎性脱髓鞘性多发性神经病 (CIDP)患者血清和脑脊液 (CSF)中抗硫脂抗体及P2蛋白抗体水平 ,探讨其临床意义和可能的致病机制。方法　应用ELISA法检测 2 4例CIDP患者血清和脑脊液中抗硫脂抗体和P2蛋白抗体水平。结果　 (1 )CIDP组血清中高滴度抗硫脂抗体与其它周围神经病 (OPN)组和其它神经系统疾病 (OND)组比较无显著的差异 (P >0 .0 5) ;脑脊液中IgM 抗硫脂抗体与各对照组比较差异有显著性 (P <0 .0 5)。 (2 )CIDP组血清中高滴度抗P2抗体与OPN、OND组比较无显著的差异 (P >0 .0 5) ;脑脊液中抗P2抗体与各对照组比较有显著性差异 (P <0 .0 5 ,P <0 .0 1 )。 (3) 1 3例抗硫脂抗体阳性CIDP患者中 9例 (69.2 % )为感觉轴索性损害 ,1 1例阴性患者中 3例 (2 7.4 % )为感觉轴索性损害 ,差异有显著性 (P <0 .0 5)。 (4) 1 8例抗P2抗体阳性CIDP患者中 ,1 3例 (72 .2 % )为轴索性损害 ,6例抗P2抗体阴性患者中 3例 (50 % )为轴索性损害 ,差异无显著性 (P >0 .0 5)。结论　CIDP患者脑脊液中IgM 抗硫脂抗体可以作为感觉轴索型周围神经病的临床诊断参考指标 ;血清和脑脊液中P2抗体的检测对CIDP诊断参考价值不大 ,可能与疾病的修复有关。Objective To study the levels of antibody to Sulfatide and P2 myelin proteins in serum and CSF of patients with chronic inflammatory demyelinating polyradiculoneuropathy(CIDP)and evaluate the clinical singnificance. Methods The levels of antibody to Sulfatide and P2 myelin proteins in serum and CSF of 24 patients with CIDP were detected by enzyme linked immunosorbent assay(ELISA). Results (1)Compared to patients with other peripherd neuropathy and other neuropathy and normal control groups,the levels of IgM antibodies to sulfatide in CSF were significantly higher in CIDP group( P <0.05). (2)Compared to patients with other neurological diseases and other neuropathy diseases and normal control groups,the levels of antibodies to P2 myelin proteins in CSF were significantly higher in CIDP group( P <0.05, P <0.01). (3)High titer anti sulfatide antibody most frequently correlated with an axonal sensory neuropathy disease. (4)High titer P2 myelin proteins antibody had no relationship with the type of disease. Conclusion Our studies demonstrate that the leves of IgM antibodies to sulfatide in CSF of patients with CIDP may indicate that sensory neuroradicula involved;Our results indicate that antibody to P2 myelin proteins may not be responsible antibody in patients with CIDP.

关 键 词：CIDP 血清 脑脊液 硫脂抗体 P2蛋白抗体 临床意义 炎性周围神经病 

分 类 号：R744.5[医药卫生—神经病学与精神病学]