炎性周围神经病患者血清和脑脊液中抗硫脂抗体的临床意义

Clinical Implication of Antibody Against Sulfatide in Guillain-Barré Syndrome Associated Chronic Inflammatory Demyelinating Polyradiculoneuropathy

目的 通过测定炎性周围神经病患者血清和脑脊液 ( CSF)中抗硫脂抗体水平 ,探讨其临床意义和可能的致病机制。方法 应用 ELISA法检测 3 0例急性吉兰 -巴雷 ( Guillain-Barré syndrome,GBS)患者、2 4例慢性吉兰 -巴雷 ( chronic inflammatory demyelinating polyradiculoneuropathy,CIDP)患者血清和 CSF中抗硫脂抗体水平。结果 ( 1 ) GBS患者血清中高滴度抗硫脂抗体与疾病组和正常对照组比较差异无显著性 ( P >0 .0 5 ) ;CSF中 Ig M-抗硫脂抗体阳性率与各对照组比较差异有极显著性 ( P <0 .0 1 ) ;( 2 ) CIDP患者血清中高滴度抗硫脂抗体与正常对照组比较差异有显著性 ( P <0 .0 5 ) ,CSF中 Ig M-抗硫脂抗体阳性率与各对照组比较差异有显著性( P <0 .0 5 ) ;( 3 )抗硫脂抗体阳性的 GBS患者多有主观感觉障碍 ,差异有显著性 ( P <0 .0 5 ) ;抗硫脂抗体阳性的CIDP患者多为感觉轴索性损害 ,差异有显著性 ( P<0 .0 5 ) ;( 4 )轻、重型组 GBS患者血清和 CSF中抗硫脂抗体水平之间差异无显著性 ( P >0 .0 5 ) ;( 5 ) GBS组、CIDP组血清中抗体水平与配对的 CSF中抗体水平无相关性。结论 ( 1 ) GBS患者 CSF中 Ig M-抗硫脂抗体有可能作为感觉神经受累的一项临床辅助参考指标 。

Objective To study the levels of antibody against sulfatide in sera and CSF of patient with Guillain-Barré syndrome (GBS) associated chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and its clinical singnificance . Methods The levels of antibody to sulfatide in sera and CSF of 30 patients with GBS and 24 patients with CIDP were detected by enzyme linked immunosorbent assay(ELISA). Results (1)Compared to patients with other neurological diseases and normal control group, the levels of the sulfatide antibodies in CSF were significantly higer in GBS group(P<0.01);The levels of the sulfatide antibodies in CSF were much higer in CIDP group(P<0.05,P<0.01).(2) High titer anti-sulfatide antibody was most frequently correlated with an axonal sensory neuropathy.(3)The level of antibodies had no relation with the severity of the disease. (4) The level of antibodies had no relation between the serum and the CSF. Conclusions Our studies demonstrate that the level of IgM-antibodies to sulfatide in CSF of patients with GBS may indicate the sensory neuroradicula involvement. Our results indicate that detection of IgM-antibodies of sulfatide in CSF of patients with CIDP may aid the clinical diagnosis of sensory axonal neuropathy.