Fryden A, Link H, Norrby E
Infect Immun. 1978 Sep;21(3):852-61. doi: 10.1128/iai.21.3.852-861.1978.
Cerebrospinal fluid (CSF) and serum from 19 patients with mumps meningitis and 19 patients with meningitis of other etiology were investigated on two or more occasions for at least 1 month after onset. Intrathecal synthesis of immunoglobulin (Ig) G was found in 55%, of IgA in 26%, and of IgM in 24% of the patients. Oligoclonal Ig was demonstrable by agarose gel electrophoresis in 37% of the patients, mostly already during the first week after onset, and could persist for years. Mumps virus antibody synthesis within the central nervous system occurred in 37% of the mumps meningitis patients. The inflammatory reaction within the central nervous system as reflected by mononuclear pleocytosis, Ig synthesis, and oligoclonal Ig was not correlated to the clinical course. The blood-brain barrier was evaluated by determination of the CSF total protein, CSF/serum albumin ratio, and CSF/serum alpha2-macroglobulin ratio. A significant correlation was found among these three parameters. Persistence of the elevated CSF/serum albumin ratio seems to influence prognosis, and this parameter is recommended for evaluation of the blood-brain barrier function.
对19例腮腺炎脑膜炎患者和19例其他病因所致脑膜炎患者的脑脊液（CSF）和血清在发病后至少1个月内进行了两次或更多次检测。55%的患者存在鞘内免疫球蛋白（Ig）G合成，26%的患者存在IgA合成，24%的患者存在IgM合成。37%的患者通过琼脂糖凝胶电泳可检测到寡克隆Ig，大多在发病后第一周即可检测到，且可持续数年。37%的腮腺炎脑膜炎患者中枢神经系统内有腮腺炎病毒抗体合成。中枢神经系统内由单核细胞增多、Ig合成和寡克隆Ig所反映的炎症反应与临床病程无关。通过测定脑脊液总蛋白、脑脊液/血清白蛋白比值和脑脊液/血清α2-巨球蛋白比值来评估血脑屏障。这三个参数之间存在显著相关性。脑脊液/血清白蛋白比值持续升高似乎会影响预后，建议用该参数评估血脑屏障功能。
