摘要
目的探讨视神经脊髓炎谱系疾病脑脊液和血清AQP4抗体/NMO-Ig G阳性患者的临床意义。方法收集样本资料库中476例样本,随访经专家门诊或会诊中心明确诊断,对其中114例AQP4抗体/NMO-Ig G阳性抗体的视神经脊髓炎、视神经脊髓炎谱系病其他临床类型(ONMSDs)及疾病对照组患者进行分析。应用猴脑组织的间接免疫荧光法检测NMO-Ig G抗体、含有人类重组全长AQP4肽段的转染细胞(HEK293细胞)为基质的间接免疫荧光法检测AQP4抗体、野生型HEK293细胞作为阴性对照基质。阳性结果判断以NMO-Ig G抗体阳性和AQP4抗体阳性或其中之一为阳性均定义为阳性。结果 NMO组、NMOSDs组及NMO+NMOSDs组,AQP4抗体/NMO-Ig G抗体检测的阳性率、敏感度、特异度、符合支持临床诊断率及预测患病率依次分别为70.3%、70.3%、92.0%、79.0%和59.7%,64.4%、64.4%、92.0%、74.3%和64.2%,67.1%、67.15、92.0%、72.9%和76.6%。使用猴脑组织基质同时检测NMO-Ig G抗体,血清和脑脊液的阳性率为49.1%和17.5%。使用转染细胞基质同时检测AQP-4抗体,血清和脑脊液的阳性率为74.6%和44.7%。结论 AQP4抗体/NMO-Ig G抗体的测定可以为临床正确诊断疾病提供有价值的信息。建议使用两种基质同时检测血清或脑脊液,可以提高阳性检测率。AQP4抗体/NMO-Ig G抗体的出现不是NMOSDs所独有或唯一,应当结合临床综合分析诊断疾病。
ObjectiveTo investigate the clinical significance of AQP4 antibody and NMO-IgG antibody in cerebrospinal fluid and serum in the diagnosis of neuromyelitis optica spectrum disorders (NMOSDs) patients.MethodsAmong 476 samples in the database, 114 cases were found to have positive AQP4 antibodies or NMO-IgG antibodies, who met the diagnostic criteria of neuromyelitis, NMOSDs or NINDS. NMO-IgG antibody was detected by indirect immunofluorescence using monkey brain tissue, AQP4 antibody was detected using indirect immunofluorescence assay on the matrix containing human recombinant full-length AQP4 peptide transfected cells (HEK293 cells), the wild-type HEK293 cells were used as negative control. The sample was evaluated as positive when level of either NMO-IgG antibody or AQP4 antibody elevated.ResultsThe positivity rate of AQP4 antibody/NMO-IgG antibody was 70.3% in NMO, 64.4% in NMOSDs, and 67.1% in NMO plus NMOSDs group. The sensitivity of AQP4 antibody/NMO-IgG antibody was 70.3% in NMO, 64.4% in NMOSDs, and 67.1% in NMO plus NMOSDs group. The specificity of AQP4 antibody/NMO-IgG antibody was 92.0% in NMO, NMOSDs, and NMO plus NMOSDs group. The percentage of numbers in accordance with clinical diagnosis was 79.0% in NMO, 74.3% in NMOSDs, and 72.9% in NMO plus NMOSDs group. The predictivity of AQP4 antibody/NMO-IgG antibody was 59.7% in NMO, 64.2% in NMOSDs, and 76.6% in NMO plus NMOSDs group. In simultaneously detection of NMO-IgG antibodies using monkey brain tissue, the positive rate of serum and cerebrospinal fluid were 49.1% and 17.5%. In simultaneous detection of AQP4 antibody on transfected cells as a substrate, the positive rate of serum and cerebrospinal fluid were 74.6% and 44.7%.ConclusionsDetermination of AQP4 antibody/NMO-IgG antibody can provide valuable information for clinical diagnosis of NMO or NMOSDs. It is recommended to use the two matrix determination of serum and CSF simultaneously to raise sensitivity. AQP4 antibody/NMO-IgG antibody is not unique to NMOSDs nor NMO. The significance of po
出处
《中华临床医师杂志（电子版）》
CAS
2015年第21期15-19,共5页
Chinese Journal of Clinicians(Electronic Edition)
基金
科技部重大专项子课题(2011ZX09307-001-07)
