Reiber Hansotto, Otto Markus, Trendelenburg Christian, Wormek Arno
Neurochemisches Labor der Neurologischen Klinik, Universität Göttingen, Robert-Koch Strasse 40, 37075 Göttingen, Germany.
EJIFCC. 2004 Aug 31;15(3):74-81. eCollection 2004 Aug.
The compilation of cerebrospinal fluid (CSF) patient data together with a graphic display of immunoglobulin patterns in a single CSF report has two main advantages: analytical and clinical; plausibility control of a complex set of data improves quality assessment and allows improved clinical specificity and sensitivity for recognition of disease-related "typical" data patterns. The widespread use of automated on-line evaluation programs can now be combined with knowledge-based programs for interpretation by clinical chemists and neurologists. These programs are based on knowledge of neuroimmunology, blood-CSF barrier function and dysfunction, influence of CSF flow on concentrations of blood-derived and brain-derived proteins in CSF, specific intrathecal antibody synthesis and relevance of brain proteins for differential diagnosis of degenerative diseases. The relevance of hyperbolic discrimination functions in quotient diagrams for the detection of intrathecal immunoglobu-lin synthesis is compared with earlier, still frequently used, linear interpretation functions. Differences found in commercially available interpretation software are discussed.
在一份脑脊液（CSF）报告中汇编患者脑脊液数据并以图形方式展示免疫球蛋白模式有两个主要优点：分析性和临床性；对一组复杂数据进行合理性控制可提高质量评估，并能提高识别疾病相关“典型”数据模式的临床特异性和敏感性。现在，自动化在线评估程序的广泛应用可以与基于知识的程序相结合，供临床化学家及神经学家进行解读。这些程序基于神经免疫学、血脑屏障功能与功能障碍、脑脊液流动对脑脊液中血液来源和脑来源蛋白质浓度的影响、鞘内特异性抗体合成以及脑蛋白在退行性疾病鉴别诊断中的相关性等知识。将商数图中双曲线判别函数在检测鞘内免疫球蛋白合成方面的相关性与早期仍经常使用的线性解读函数进行比较。讨论了市售解读软件中发现的差异。
