通过测定78例视神经脊髓炎患者血清中NMO-IgG水平判断其临床诊断价值

Clinical Value of Serum NMO-IgG in Patients with Neuromyelitis Optica

目的通过测定视神经脊髓炎(NMO)患者血清中的NMO-IgG水平,判断NMO-IgG对视神经脊髓炎的临床诊断价值。方法选取本院2006年9月至2014年6月NMO患者78例,长节段横惯性脊髓炎(LETM)患者32例,多发性硬化(MS)患者54例,以及40名健康志愿者,收集其血清,采用ELISA法检测血清NMO-IgG水平。结果 NMO组NMO-IgG阳性率为61.5%(48/78),LETM组阳性率为43.8%(14/32),MS组阳性率为9.3%(5/54),对照组阳性率为0(0/40)。NMO组与LETM组的血清NMO-IgG阳性率均显著高于MS组(P<0.05),支持两者都属于视神经脊髓炎疾病谱(NMOSD)。其中男性患者NMO-IgG阳性率为14.5%(9/62),女性患者NMO-IgG阳性率为56.9%(58/102),女性患者的NMO-IgG阳性率显著高于男性患者。单相病程组血清NMO-IgG阳性率为26.3%(5/19),多相病程组血清NMO-IgG阳性率为72.9%(43/59),多相病程与NMO-IgG呈正相关,单相病程与NMO-IgG呈负相关。血清NMO-IgG诊断NMO的灵敏度为61.5%(48/78),以MS为对照,其诊断NMO的特异度为90.7%(49/54),以MS同对照组一起为对照,其诊断特异度为94.7%(89/94)。结论利用血清NMO-IgG检测来诊断NMO具有较高的敏感性及很强的特异性,可以有效的鉴别NMO与MS,从而有助于病人的确诊及临床合理用药,应该在临床上推广使用。

Objective To explore the clinical value of serum NMO-IgG in patients with neuromyelitis optica （NMO）. Methods The serum NMO-IgG levels in 78 cases of NMO patients,32 cases of patients with long segment transverse inertia myelitis （LETM） ,54 cases of patients with multiple sclerosis （MS）, and 40 healthy volunteers were determined by ELISA. Results The positive rate of NMO-IgG in NMO group, LETM group and MS group were 61.5% （48/78）,43.8% （14/32） and 9.3% （5/54） respectively. The positive rates of NMO-IgG in NMO group and LETM group were significantly higher than that of MS group and healthy controls （ P 〈 0.05 ）. The positive rate of NMO-IgG in male and female patients were 14, 5% （ 9/62 ） and 56.9% （58/102） with significantly difference. The positive rate of serum NMO-IgG in mono-phase and multiphase patients were 26.3 % （5/19） and 72.9% （43/59） respectively. The serum NMO- IgG levels was positively correlated with muhiphase and negatively correlated with mono-phase of NMO. The specificity of serum NMOIgG for NMO diagnosis was 90.7% （49/54） while taking MS as control. Conclusion The serum NMO-IgG has very important clinical significance and could be used for diagnosis of neuromyelitis optica with high sensitivity and specificity.