Zeman A Z, Kidd D, McLean B N, Kelly M A, Francis D A, Miller D H, Kendall B E, Rudge P, Thompson E J, McDonald W I
Institute of Neurology, University of London, UK.
J Neurol Neurosurg Psychiatry. 1996 Jan;60(1):27-30. doi: 10.1136/jnnp.60.1.27.
To determine whether oligoclonal band (OCB) negative multiple sclerosis is a reliable diagnosis and, if so, whether it has a distinctive prognosis.
Retrospective and matched prospective comparison of the clinical and laboratory features of patients with clinical definite multiple sclerosis with and without intrathecal synthesis of oligoclonal IgG.
Thirty four patients were identified with apparent OCB negative clinically definite multiple sclerosis. The results of oligoclonal banding proved to have been equivocal in 14 of 34; the clinical diagnosis of multiple sclerosis was questionable in 8 of 34. The remaining 12 patients with "true" OCB negative multiple sclerosis were significantly less disabled than matched OCB positive controls. Re-examination of CSF-serum pairs from six OCB negative patients showed that three remained OCB negative while three showed evidence of intrathecal synthesis of OCBs.
OCB negative clinically definite multiple sclerosis is rare and should be diagnosed with caution; in unequivocal cases it seems to have a relatively benign prognosis.
确定寡克隆带（OCB）阴性的多发性硬化症是否为可靠的诊断，若如此，其预后是否具有独特性。
对临床确诊的多发性硬化症患者鞘内合成寡克隆IgG的情况进行回顾性及匹配的前瞻性比较，分析其临床和实验室特征。
共识别出34例临床确诊的明显OCB阴性的多发性硬化症患者。34例中有14例寡克隆带检测结果不明确；34例中有8例多发性硬化症的临床诊断存疑。其余12例“真正”OCB阴性的多发性硬化症患者的残疾程度明显低于匹配的OCB阳性对照组。对6例OCB阴性患者的脑脊液 - 血清样本进行复查，结果显示3例仍为OCB阴性，3例有鞘内合成OCB的证据。
OCB阴性的临床确诊多发性硬化症罕见，诊断时应谨慎；在明确的病例中，其预后似乎相对较好。
