Johnson K P, Nelson B J
Ann Neurol. 1977 Nov;2(5):425-31. doi: 10.1002/ana.410020515.
Early, atypical, or progressive cases of multiple sclerosis (MS) may be hard to diagnose. Until recently, assays of the most common abnormalities in cerebrospinal fluid were not available in clinical diagnostic laboratories, but now they can be done with relative ease and adequate standardization. With the newer techniques the CSF is abnormal in more than 90% of clinically definite cases of MS, and determination of such changes can be a major aid in diagnosis. The most common CSF abnormalities are discussed: elevation of immunoglobulin G(IgG), expressed as percentage of total protein; elevation of the IgG/albumin index; and presence of oligoclonal IgG bands. Not only does assessment of these CSF proteins provide an improved aid to diagnosis, but their study may furnish important clues to the cause and pathogenesis of MS as well.
多发性硬化症（MS）的早期、非典型或进展性病例可能难以诊断。直到最近，临床诊断实验室还无法进行脑脊液中最常见异常的检测，但现在可以相对轻松且有充分标准化地完成这些检测。采用更新的技术，在超过90%的临床确诊MS病例中脑脊液是异常的，确定这些变化对诊断有很大帮助。文中讨论了脑脊液最常见的异常情况：免疫球蛋白G（IgG）升高，以占总蛋白的百分比表示；IgG/白蛋白指数升高；以及寡克隆IgG带的存在。对这些脑脊液蛋白质的评估不仅有助于改进诊断，而且对其研究也可能为MS的病因和发病机制提供重要线索。
