水通道蛋白4抗体检测对视神经脊髓炎的诊断价值

Diagnostic value of detection of Aquaporin-4 antibody on neuromyelitis optica

目的探讨水通道蛋白4（AQP4）抗体检测对视神经脊髓炎（NMO）的诊断价值。方法采用表达人AQP4基因的人胚肾（HEK）293细胞株分别对35例NMO患者（NMO组）、14例NMO高危综合征患者（HRS组）、37例多发性硬化患者（MS组）、23例其他脱髓鞘疾病患者（ODD组）及75例其他神经系统疾病患者（MD组）的血标本进行AQP4抗体检测,比较各组抗体的阳性率。结果 NMO组中31例患者（88.6%）及HRS组中6例患者（42.9%）AQP4抗体检测为阳性;MS组、ODD组和MD组患者AQP4抗体检测均为阴性。NMO组AQP4抗体检测阳性的敏感性为88.6%,95%CI：73.11%~96.79%;HRS组AQP4抗体检测阳性的敏感性为42.9%,95%C：I 16.97%~68.83%;NMO患者AQP4抗体检测阳性的特异性为100%。结论 AQP4抗体检测对NMO及其疾病谱早期确诊有重要意义,且具有较高的敏感性和特异性。

Objective To investigate the diagnostic value of detection of Aquaporin-4（AQP4） antibody on neuromyelitis optica（NMO）.Methods Human embryonic kidney（HEK） 293 cell lines which express human AQP4 were used to detect AQP4 antibody in 35 patients with NMO（NMO group）,14 patients with NMO high-risk syndromes（HRS group）,37 patients with multiple sclerosis（MS group）,23 patients with other demyelinating diseases（ODD group）,75 patients with Miscellaneous disease（MD group）,then the positive rates of AQP4 antibody was compared among all the groups.Results The antibody of AQP4 were positive in 31 patients with NMO（88.6%） and in 6 patients with HRS（42.9%）.The antibody of AQP4 were all negative in patients with MS,ODD and MD.The sensitivity of positive AQP4 antibody was 88.6% in NMO group,95%CI： 73.11%-96.79%;and the sensitivity of positive AQP4 antibody was 42.9% in HRS group,95%CI： 16.97%-68.83%.The specificity of positive AQP4 antibody was 100% in NMO patients.Conclusion It is confirmed that detection for AQP4 antibody have significant value for early diagnosis of NMO and its related diseases with high sensitivity and high specificity.