寡克隆区带及抗水通道蛋白4抗体在多发性硬化诊断中的意义

Significance of oligoclonal bands and aquaporin-4 antibody in diagnosis of multiple sclerosis

目的通过观察多发性硬化(multiple sclerosis,MS)患者寡克隆区带(oligoclonal bands,OCB)及抗水通道蛋白4(aquaporin-4,AQP4)抗体的阳性率,为临床MS的诊断及鉴别诊断提供一定的参考。方法入组30例MS、48例神经系统非炎性病变(neurological non-inflammatory disease,NND)及50例外科手术患者。分析3组患者OCB、脑脊液及血清抗AQP4抗体阳性率的差异。结果 NND组与外科手术组OCB、脑脊液及血清抗AQP4抗体阳性率的差异无统计学意义(P>0.05)。MS组与对照组(NND组+外科手术组)脑脊液抗AQP4抗体阳性率差异无统计学意义(P>0.05),MS组与对照组OCB、血清抗AQP4抗体阳性率差异有统计学意义(P<0.01)。结论 OCB阳性对MS具有诊断意义。MS部分患者可表现为血清或脑脊液抗AQP4抗体阳性,诊断时需结合病史、临床体征及影像学特点等综合分析。

Objective To observe the positive rate of oligoclonal bands （OCB） and aquaporin 4 （AQ（）4） antibody in pa tients of multiple sclerosis （MS）, in order to give help to clinical diagnosis and differential diagnosis of MS. Methods Thirty cases of MS, 48 cases of neurological non inflammatory disease （NND） and 50 cases of surgery were involved in this re search. The statistical analysis was developed on data of the positive rate of OCB, cerebrospinal fluid AQP4 antibody and serum AQP4 antibody between the three groups. Results The positive rate of OCB, cerebrospinal fluid AQP4 antibody and serum AQP4 antibody were all not significantly different between the NND group and surgical group （P〉0.05）. The positive rate of cerebrospinal fluid AQP4 antibody was not significantly different between the MS group and control group（NND group-surgical group） （P〉0.05）. The positive rate of OCB and serum AQP4 antibody were significantly different between the MS group and control group （P〈0.01）. Conclusion The positive OCB is significant in diagnosis of MS. The serum or cerebrospinal fluid AQP4 antibody can be positive in a part of patients of MS. The diagnosis of MS needs a comprehensive analysis according to case history, clinic signs, radiologic feathers, etc.