中华神经科杂志
中華神經科雜誌
중화신경과잡지
Chinese Journal of Neurology
2014年
10期
676-679
,共4页
视神经脊髓炎%水通道蛋白质4%免疫球蛋白G%荧光抗体技术,间接
視神經脊髓炎%水通道蛋白質4%免疫毬蛋白G%熒光抗體技術,間接
시신경척수염%수통도단백질4%면역구단백G%형광항체기술,간접
Neuromyelitis optica%Aquaporin 4%Immunoglobulin G%Fluorescent antibody technique,indirect
目的 探讨基于猴视神经和稳定转染水通道蛋白4 (AQP4)细胞的间接免疫荧光法(indirect immunofluorescence assay,ⅡFA)同时检测血清和脑脊液AQP4-IgG在视神经脊髓炎(NMO)中的应用.方法 应用猴视神经/细胞IIFA,同时检测32例NMO、41例多发性硬化(MS)和33例神经系统非炎性疾病(NIND)患者血清和脑脊液AQP4-IgG以及20名健康人血清AQP4-IgG,并进行对比分析.结果 (1)无论采用视神经IIFA还是细胞IIFA,与MS和NIND患者及健康人相比,NMO患者血清AQP4-IgG阳性率显著升高[视神经IIFA:NMO 46.9％ (15/32),MS 7.3％ (3/41),NIND3.0％ (1/33),健康人0(0/20),P＜0.01;细胞IIFA:NMO 84.4％ (27/32),MS 2.4％ (1/41),NIND 3.0％ (1/33),健康人0(0/20),P＜0.01],与MS及NIND患者相比,NMO患者脑脊液AQP4-IgG阳性率显著升高[视神经ⅡFA:NMO 21.9％ (7/32),MS 0(0/41),NIND 0(0/33),P＜0.01;细胞IIFA:NMO 56.3％ (18/32),MS 0 (0/41),NIND 0 (0/33),P＜0.01];血清标本(视神经IIFA46.9％,细胞IIFA 84.4％)在诊断NMO时的敏感度明显高于脑脊液标本(视神经IIFA 21.9％,P＜0.05;细胞IIFA 56.3％,P＜0.05),两种标本特异度差异无统计学意义;同时检测血清和脑脊液,可提高血清AQP4-IgG诊断的敏感度(视神经IIFA:46.9％比50.0％;细胞IIFA:84.4％比87.5％),而特异度无改变.(2)无论血清还是脑脊液标本,与视神经IIFA(血清标本46.9％,脑脊液标本21.9％)相比,细胞IIFA具有更好的敏感度(血清标本84.4％,P＜0.01;脑脊液标本56.3％,P＜0.01),特异度差异无统计学意义.结论 (1)视神经IIFA检测AQP4-IgG有助于NMO诊断,但敏感度低于细胞IIFA;(2)同时检测血清和脑脊液AQP4-IgG在诊断NMO时具有更好的临床价值.
目的 探討基于猴視神經和穩定轉染水通道蛋白4 (AQP4)細胞的間接免疫熒光法(indirect immunofluorescence assay,ⅡFA)同時檢測血清和腦脊液AQP4-IgG在視神經脊髓炎(NMO)中的應用.方法 應用猴視神經/細胞IIFA,同時檢測32例NMO、41例多髮性硬化(MS)和33例神經繫統非炎性疾病(NIND)患者血清和腦脊液AQP4-IgG以及20名健康人血清AQP4-IgG,併進行對比分析.結果 (1)無論採用視神經IIFA還是細胞IIFA,與MS和NIND患者及健康人相比,NMO患者血清AQP4-IgG暘性率顯著升高[視神經IIFA:NMO 46.9％ (15/32),MS 7.3％ (3/41),NIND3.0％ (1/33),健康人0(0/20),P＜0.01;細胞IIFA:NMO 84.4％ (27/32),MS 2.4％ (1/41),NIND 3.0％ (1/33),健康人0(0/20),P＜0.01],與MS及NIND患者相比,NMO患者腦脊液AQP4-IgG暘性率顯著升高[視神經ⅡFA:NMO 21.9％ (7/32),MS 0(0/41),NIND 0(0/33),P＜0.01;細胞IIFA:NMO 56.3％ (18/32),MS 0 (0/41),NIND 0 (0/33),P＜0.01];血清標本(視神經IIFA46.9％,細胞IIFA 84.4％)在診斷NMO時的敏感度明顯高于腦脊液標本(視神經IIFA 21.9％,P＜0.05;細胞IIFA 56.3％,P＜0.05),兩種標本特異度差異無統計學意義;同時檢測血清和腦脊液,可提高血清AQP4-IgG診斷的敏感度(視神經IIFA:46.9％比50.0％;細胞IIFA:84.4％比87.5％),而特異度無改變.(2)無論血清還是腦脊液標本,與視神經IIFA(血清標本46.9％,腦脊液標本21.9％)相比,細胞IIFA具有更好的敏感度(血清標本84.4％,P＜0.01;腦脊液標本56.3％,P＜0.01),特異度差異無統計學意義.結論 (1)視神經IIFA檢測AQP4-IgG有助于NMO診斷,但敏感度低于細胞IIFA;(2)同時檢測血清和腦脊液AQP4-IgG在診斷NMO時具有更好的臨床價值.
목적 탐토기우후시신경화은정전염수통도단백4 (AQP4)세포적간접면역형광법(indirect immunofluorescence assay,ⅡFA)동시검측혈청화뇌척액AQP4-IgG재시신경척수염(NMO)중적응용.방법 응용후시신경/세포IIFA,동시검측32례NMO、41례다발성경화(MS)화33례신경계통비염성질병(NIND)환자혈청화뇌척액AQP4-IgG이급20명건강인혈청AQP4-IgG,병진행대비분석.결과 (1)무론채용시신경IIFA환시세포IIFA,여MS화NIND환자급건강인상비,NMO환자혈청AQP4-IgG양성솔현저승고[시신경IIFA:NMO 46.9％ (15/32),MS 7.3％ (3/41),NIND3.0％ (1/33),건강인0(0/20),P＜0.01;세포IIFA:NMO 84.4％ (27/32),MS 2.4％ (1/41),NIND 3.0％ (1/33),건강인0(0/20),P＜0.01],여MS급NIND환자상비,NMO환자뇌척액AQP4-IgG양성솔현저승고[시신경ⅡFA:NMO 21.9％ (7/32),MS 0(0/41),NIND 0(0/33),P＜0.01;세포IIFA:NMO 56.3％ (18/32),MS 0 (0/41),NIND 0 (0/33),P＜0.01];혈청표본(시신경IIFA46.9％,세포IIFA 84.4％)재진단NMO시적민감도명현고우뇌척액표본(시신경IIFA 21.9％,P＜0.05;세포IIFA 56.3％,P＜0.05),량충표본특이도차이무통계학의의;동시검측혈청화뇌척액,가제고혈청AQP4-IgG진단적민감도(시신경IIFA:46.9％비50.0％;세포IIFA:84.4％비87.5％),이특이도무개변.(2)무론혈청환시뇌척액표본,여시신경IIFA(혈청표본46.9％,뇌척액표본21.9％)상비,세포IIFA구유경호적민감도(혈청표본84.4％,P＜0.01;뇌척액표본56.3％,P＜0.01),특이도차이무통계학의의.결론 (1)시신경IIFA검측AQP4-IgG유조우NMO진단,단민감도저우세포IIFA;(2)동시검측혈청화뇌척액AQP4-IgG재진단NMO시구유경호적림상개치.
Objective To explore the diagnostic value of serum and cerebral spinal fluid (CSF) aquaporin 4(AQP4)-IgG detected by indirect immunofluorescence assay (ⅡFA) using monkey optical nerve and AQP4 transfected cell as base in neuromyelitis optica (NMO).Methods Serum and CSF AQP4-IgG in 32 NMO patients,41 multiple sclerosis (MS) patients,33 non-inflammatory neurological disease (NIND) patients and serum AQP4-IgG in 20 healthy controls (HC) were detected by monkey optical nerve/AQP4 transfected cell-based IIFA.Results (1) In both optical nerve and AQP4 transfected cell based IIFA,compared with MS,NIND and HC,the patients with NMO had significantly higher positive rate of AQP4-IgG in both serum (optical nerve-based IIFA:NMO 46.9％ (15/32),MS 7.3％ (3/41),NIND 3.0％ (1/33),HC 0 (0/20),P ＜ 0.01 ; cell-based IIFA:NMO 84.4％ (27/32),MS 2.4％ (1/41),NIND 3.0％ (1/33),HC 0 (0/20),P ＜0.01) and CSF (optical nerve-based ⅡFA:NMO 21.9％ (7/32),MS 0 (0/41),NIND 0 (0/33),P ＜ 0.01 ; cell-based IIFA:NMO 56.3％ (18/32),MS 0 (0/41),NIND 0(0/33),P＜0.01); sensitivity of serum AQP4-IgG (optical nerve-based IIFA 46.9％; cell-based IIFA 84.4％) was significantly higher than that of CSF AQP4-IgG (optical nerve-based IIFA 21.9％,P ＜0.01 ; cell-based IIFA 56.3 ％,P ＜ 0.05),while no significant difference was found in specificity between serum and CSF AQP4-IgG in diagnosing NMO; using combination of serum and CSF AQP4-IgG applied,the sensitivity increased (optical nerve-based IlFA 46.9％ vs 50.0％ ; cell-based IIFA 84.4％ vs 87.5％) while specificity remained no change.(2) Compared with optical nerve-based IIFA (serum 46.9％,CSF 21.9％),cell-based IIFA had higher sensitivity in diagnosing NMO (serum 84.4％ ; CSF 56.3％,P ＜ 0.01),while no significant difference of specificity between these two methods.Conclusion It has better clinical value to detect serum and CSF AQP4-IgG at the same time by AQP4 transfected cell based IIFA in diagnosing NMO.
