Nikoskelainen E, Frey H, Salmi A
Ann Neurol. 1981 Jun;9(6):545-50. doi: 10.1002/ana.410090606.
Forty-eight patients with optic neuritis (ON), first seen in 1970 to 1973, were neurologically and neuroophthalmologically reexamined after 7 to 10 years. Twenty-seven patients (56%) had probable MS, and 9 (19%) had possible MS. During the attack of ON, the cerebrospinal fluid (CSF) samples and serum/CSF measles antibody ratios were studied. Twenty patients had increased relative immunoglobulin G (IgG) (% of total protein) in their CSF; 19 of these had probable or possible MS. However, 17 of 28 patients with a normal relative IgG value had also developed MS. CSF electrophoresis was abnormal in 20 patients with ON; reexamination showed that 19 had probable or possible MS. Sixteen of 27 patients with normal electrophoresis had also developed MS. Serum/CSF measles antibody ratio had decreased in 19 patients; 13 of these had probable MS and 3 had possible MS. Of 29 patients with a normal measles antibody ratio, 14 had probable MS and 6 had possible MS. The conclusion is that examination of the CSF in ON gives valuable prognostic information because increased relative IgG, abnormal electrophoresis, or a decreased measles antibody ratio implies a high risk of developing MS. A normal CSF does not, however, rule out the possibility of dissemination.
1970年至1973年间首次就诊的48例视神经炎（ON）患者在7至10年后接受了神经科和神经眼科的复查。27例（56%）患者可能患有多发性硬化症（MS），9例（19%）可能患有MS。在ON发作期间，对脑脊液（CSF）样本和血清/CSF麻疹抗体比率进行了研究。20例患者的CSF中相对免疫球蛋白G（IgG）（占总蛋白的百分比）升高；其中19例可能患有或可能患有MS。然而，28例相对IgG值正常的患者中有17例也患上了MS。20例ON患者的CSF电泳异常；复查显示，19例可能患有或可能患有MS。27例电泳正常的患者中有16例也患上了MS。19例患者的血清/CSF麻疹抗体比率下降；其中13例可能患有MS，3例可能患有MS。在29例麻疹抗体比率正常的患者中，14例可能患有MS，6例可能患有MS。结论是，对视神经炎患者的脑脊液检查可提供有价值的预后信息，因为相对IgG升高、电泳异常或麻疹抗体比率降低意味着发生MS的风险很高。然而，脑脊液正常并不能排除疾病播散的可能性。
