Kaiser R, Czygan M, Kaufmann R, Lücking C H
Neurologische Klinik und Poliklinik, Albert-Ludwigs-Universität, Freiburg.
Nervenarzt. 1995 Aug;66(8):618-23.
Two quantitative methods of determining the intrathecal synthesis of IgG were tested for their usefulness in deciding about the necessity of further investigations of oligoclonal bands (OCB) in the CSF. For this purpose, in 2003 patients with various neurological diseases the intrathecal synthesis of IgG was determined by Reiber's formula and by the IgG index, as well as by the demonstration of OCB by isoelectric focusing (IEF). While OCB could be detected in no patient with an IgG index < 0.45, these bands were always demonstrated in patients with an index > 0.80. Even though arrange of 0.45-0.8 OCB was only detected in 268/1316 patients (20.4%), in 190/268 samples (70.8%) OCB were the only criterion for intrathecal synthesis of IgG. Calculation of intrathecal synthesis of IgG by Reiber's formula was less helpful in deciding about the necessity for IEF. Even though they had no intrathecal synthesis of IgG, as calculated by Reiber's formula, 189/1472 patients (12.8%) had OCB in the CSF. OCB were always detected if local production of IgG was > 12%. In patients with a severe damage of the blood-CSF barrier, calculation of the IgG index gave more false-positive results than calculations using Reiber's formula.
测试了两种定量测定鞘内IgG合成的方法，以确定其在判断是否有必要进一步检测脑脊液中寡克隆带（OCB）方面的实用性。为此，对2003例患有各种神经系统疾病的患者，通过赖伯公式和IgG指数测定鞘内IgG合成，并通过等电聚焦（IEF）检测OCB。当IgG指数<0.45时，未在任何患者中检测到OCB，而指数>0.80的患者中总是能检测到这些条带。尽管仅在268/1316例患者（20.4%）中检测到OCB处于0.45 - 0.8的范围，但在190/268个样本（70.8%）中，OCB是鞘内IgG合成的唯一标准。用赖伯公式计算鞘内IgG合成对于判断是否有必要进行IEF帮助较小。尽管根据赖伯公式计算，189/1472例患者（12.8%）脑脊液中没有鞘内IgG合成，但却检测到了OCB。如果IgG的局部产生>12%，则总能检测到OCB。在血脑屏障严重受损的患者中，计算IgG指数比使用赖伯公式计算产生更多假阳性结果。
