CAJ | 학술논문

目的探讨视神经脊髓炎IgG抗体(NMO-IgG)对视神经脊髓炎和多发性硬化的鉴别诊断价值,分析NMO-IgG与视神经脊髓炎临床特点的相关性.方法 2006年12月至2008年6月收集首都医科大学宣武医院就诊的急性期视神经脊髓炎41例,多发性硬化44例和40名健康对照者,间接免疫荧光法检测血清NMO-IgG,扩展残疾状态量表评价疾病严重程度,分析NMO-IgG与视神经脊髓炎临床特点、影像学的相关性.结果视神经脊髓炎组NMO-IgG阳性率70.7%(29/41),多发性硬化组9.1%(4/44)和健康组0%,差异有统计学意义(P＜0.01).NMO-IgG区分视神经脊髓炎和多发性硬化的敏感性70.7%,特异性90.9%.NMO-IgG阳性的患者疾病严重程度评分高于阴性组(P＜0.05);NMO-IgG阳性患者脊髓3个节段以上受累占93.1%,高于阴性组66.7%,但差异无统计学意义(P=0.154).结论 NMO-IgG是视神经脊髓炎特异的生物学标记物,有助于视神经脊髓炎与多发性硬化的区分.NMO-IgG可能与疾病严重程度有关.
목적 탐토시신경척수염IgG항체(NMO-IgG)대시신경척수염화다발성경화적감별진단개치,분석NMO-IgG여시신경척수염림상특점적상관성.방법 2006년12월지2008년6월수집수도의과대학선무의원취진적급성기시신경척수염41례,다발성경화44례화40명건강대조자,간접면역형광법검측혈청NMO-IgG,확전잔질상태량표평개질병엄중정도,분석NMO-IgG여시신경척수염림상특점、영상학적상관성.결과 시신경척수염조NMO-IgG양성솔70.7%(29/41),다발성경화조9.1%(4/44)화건강조0%,차이유통계학의의(P＜0.01).NMO-IgG구분시신경척수염화다발성경화적민감성70.7%,특이성90.9%.NMO-IgG양성적환자질병엄중정도평분고우음성조(P＜0.05);NMO-IgG양성환자척수3개절단이상수루점93.1%,고우음성조66.7%,단차이무통계학의의(P=0.154).결론 NMO-IgG시시신경척수염특이적생물학표기물,유조우시신경척수염여다발성경화적구분.NMO-IgG가능여질병엄중정도유관.
Objective To investigate the differential diagnostic value of NMO-IgG for neuromyelitis optica (NMO) versus multiple sclerosis (MS) and to analyze its possible clinical features related to NMOIgG. Methods Forty-one NMO patients and 44 MS patients in acute phase and 40 healthy controls were investigated. Serum NMO-lgG was tested by indirect immunofluorescence assay. The disability severity in NMO and MS patients was assessed by Expanded Disability Status Scale (EDSS). Clinical features and MRI imaging profiles were analyzed between NMO-IgG positive patients and negative ones. Results 70. 7% (29/41 ) NMO patients were NMO-IgG positive compared to 9. 1% (4/44) MS patients and all healthy controls were NMO-IgG negative (P ＜ 0. 01 ). The sensitivity and specificity were 70. 7% and 90. 9% respectively when NMO-IgG was used to discriminate NMO from MS. NMO patients with positive NMO-IgG had significantly higher EDSS scores ( P ＜ 0. 05 ) . More NMO-IgG seropositive patients had longitudinally extensive cord lesions ( ≥3 segments) than the NMO-IgG seronegative patients (93. 1% vs 66. 7% ). But the difference was insignificant. Conclusion NMO-IgG is a specific biomarker of NMO. NMO-IgG can facilitate an early differentiation of NMO from MS. NMO-IgG seropositivity is related to graver symptoms and it may predict an aggravation.