急性期多发性硬化患者脑脊液及血清髓鞘少突胶质细胞糖蛋白抗体、髓鞘相关生长抑制因子抗体的检测及其意义

Measurement and its significance of cerebrospinal fluid and serum anti-myelin oligodendrocyte glycoprotein antibody and anti-Nogo-A antibody at acute stage multiple sclerosis patients

目的探讨急性期多发性硬化(MS)患者脑脊液(CSF)和血清髓鞘少突胶质细胞糖蛋白抗体(MOG-Ab)、髓鞘相关生长抑制因子抗体(Nogo-A-Ab)的异常率及其临床意义。方法选取临床确诊的MS(急性发作期)患者30例、其他炎症性神经疾病(OIND)患者30例和非炎症性神经疾病(NIND)患者30例;应用ELISA法检测3组患者CSF、血清MOG-Ab及Nogo-A-Ab。结果 MS组CSF和血清MOG-Ab阳性率(46.7%,40.0%)与OIND组(10.0%,6.7%)及NIND组(3.3%,0)比较,差异有统计学意义(均P<0.05);OIND组与NIND组比较,差异无统计学意义;MS组CSFNogo-A-Ab阳性率(36.7%)与OIND组(6.7%)及NIND组(0)比较,差异有统计学意义(均P<0.05),血清Nogo-A-Ab阳性率(10.0%)与OIND组(3.3%)及NIND组(0)比较,差异无统计学意义;OIND组CSF和血清Nogo-A-Ab阳性率与NIND组比较,差异均无统计学意义;MS组CSF与血清MOG-Ab阳性率比较,差异无统计学意义,CSF与血清Nogo-A-Ab阳性率比较,差异有统计学意义(P<0.05);MS组CSFMOG-Ab及Nogo-A-Ab同为阳性有7例(23.3%),而未见血清两者均阳性者。结论 MS患者急性期检测CSF及血清MOG-Ab,以及CSFNogo-A-Ab有助于明确MS诊断。

Objective To explore the measurement and its significances of cerebrospinal fluid（CSF） and serum anti-myelin oligodendrocyte glycoprotein antibody（MOG-Ab） and anti-Nogo-A antibody（Nogo-A-Ab） in acute multiple sclerosis（MS） patients.Methods There were 30 patients with clinical definite MS （acute phase） and 30 patients with other inflammatory neurological disease（OIND）,30 patients with non-inflammatory neurological diseases（NIND） in this study.MOG-Ab and Nogo-A-Ab of CSF and serum in the 3 groups were measured by ELISA.Results There were significant differences in the positive rates of CSF and serum MOG-Ab between MS group（respectively 46.7%,40.0%） with OIND group （respectively 10.0%,6.7%） and NIND group （respectively 3.3%,0） （all P〈0.05）,but there was no significant difference of those between OIND group and NIND group.There were significant differences in the positive rate of CSF Nogo-A-Ab between MS group（36.7%） and OIND group（6.7%）,NIND group（0） （all P〈0.05）.But there were not significant differences of serum Nogo-A-Ab among MS group （10.0%）,OIND group （3.3%） and NIND group （0）.There was no significant difference in the positive percentage of CSF and serum Nogo-A-Ab between OIND group and NIND group.There was no significant difference in the positive percentage of MOG-Ab between CSF and serum in the MS group,but there was significant difference in the positive percentage of Nogo-A-Ab between CSF and serum （P〈0.05）.There were 7 cases with MS（23.3%） both MOG-Ab and Nogo-A-Ab positive in CSF,and there was no one in serum.Conclusion The measurement of CSF and serum MOG-Ab and CSF Nogo-A-Ab at acute stage MS patient is helpful to the diagnosis.