Bloomer L C, Bray P F
Clin Chem. 1981 Dec;27(12):2011-3.
We compared three methods of analysis for IgG in cerebrospinal fluid, using samples from 158 patients with clinically suspected multiple sclerosis and from 200 neurological controls. The tests were: search for oligoclonal bands, calculation of rate of synthesis of IgG in the cerebrospinal fluid, and determination of the IgG/albumin ratio. Paired cerebrospinal fluid and serum samples were collected and their IgG and albumin concentrations measured. Oligoclonal bands were detected by electrophoresis on agarose. Positive results were obtained in 94, 75, and 67% of patients with probable or definite multiple sclerosis by the three respective methods. In contrast, for patients for whom the clinical diagnosis of multiple sclerosis was considered possible, positive results were obtained in 10, 43, and 13%, respectively. Evidently, detection of oligoclonal bands remains the best single test for the presence of abnormal IgG in suspected multiple sclerosis patients. A combination of the first two tests is most sensitive for both probable and definite multiple sclerosis (97%) and possible multiple sclerosis (50%). Some infectious or immunologic disorders can also produce these IgG abnormalities, but they can usually be distinguished from multiple sclerosis by other clinical and laboratory data.
我们使用来自158例临床疑似多发性硬化症患者和200例神经系统对照者的样本，比较了三种脑脊液中IgG的分析方法。这些检测方法包括：寻找寡克隆带、计算脑脊液中IgG的合成率以及测定IgG/白蛋白比值。采集配对的脑脊液和血清样本，并测量其IgG和白蛋白浓度。通过琼脂糖电泳检测寡克隆带。三种方法在可能或确诊的多发性硬化症患者中分别有94%、75%和67%获得阳性结果。相比之下，对于临床诊断可能为多发性硬化症的患者，阳性结果分别为10%、43%和13%。显然，对于疑似多发性硬化症患者，检测寡克隆带仍然是检测异常IgG存在的最佳单一检测方法。前两种检测方法联合使用对可能和确诊的多发性硬化症（97%）以及可能的多发性硬化症（50%）最为敏感。一些感染性或免疫性疾病也可导致这些IgG异常，但通常可通过其他临床和实验室数据与多发性硬化症相鉴别。
