Harrington M G, Kennedy P G
Biochemical Genetics Section, National Institute of Mental Health, Bethesda, MD 20892.
Postgrad Med J. 1987 Sep;63(743):735-40. doi: 10.1136/pgmj.63.743.735.
The clinical diagnosis of definite multiple sclerosis is supported by abnormalities in the cerebrospinal fluid: variable mild pleocytosis and elevation of total protein, moderately elevated total IgG in most patients, and the almost invariable presence of discrete immunoglobulins after electrophoresis, the oligoclonal bands. The oligoclonal bands are non-specific, and are seen in most diseases of the nervous system, but their temporal uniformity in each patient with multiple sclerosis is characteristic. Prognostically, patients with a single episode of optic neuritis or paraesthesia who have oligoclonal bands are more likely to develop multiple sclerosis than if the spinal fluid were normal. In the Guillain-Barré syndrome, the spinal fluid total protein is transiently elevated, with no pleocytosis. Oligoclonal bands are usually found in the acute phase and only persist in those patients with chronic or relapsing polyneuropathy.
可变的轻度细胞增多和总蛋白升高,大多数患者总IgG中度升高,电泳后几乎总是存在离散的免疫球蛋白,即寡克隆带。寡克隆带是非特异性的,在大多数神经系统疾病中都可见,但它们在每个多发性硬化症患者中的时间一致性是其特征。从预后来看,患有视神经炎或感觉异常单次发作且有寡克隆带的患者比脑脊液正常时更有可能发展为多发性硬化症。在吉兰 - 巴雷综合征中,脑脊液总蛋白短暂升高,无细胞增多。寡克隆带通常在急性期发现,仅在慢性或复发性多发性神经病患者中持续存在。