The clinical application of Protis system in the evaluation of intrathecal IgG synthesis and blood-CSF barrier lesion in patients with neurological diseases / 中华检验医学杂志

ABSTRACT

Objective To analyze blood-CSF barrier and cerebrospinal intrathecal IgG synthesis in patients of multiple sclerosis, and explore the Protis software, IgG index and IgG synthesis rate in the and evaluation for cerebrospinal intrathecal IgG synthesis and blood-CSF barrier dysfunction. Methods 134 patients with neurological diseases were divided into threes groups, including multiple sclerosis group (34 cases), disease control group(80 cases) and control group(20 cases). IgG and ALB concentration of CSF and blood was detected by BN-Ⅱ. The oligoclonal IgG was detected by immunofixation electrophoresis. The relationship between Protis software results and IgG index or IgG synthesis rate was calculated and analyzed. Results The function of blood-brain barrier was almost normal in multiple sclerosis group,QALB was 4.5×10-3[(3.1-7.6)×10-3], there was no significance compared with control group (D=5.25, P>0.05). there were 31 patients with oligaclonal bands in cerebrospinal fluids in multiple sclerosis group (34 patients) with the positive rate of 91.2%. In multiple sclerosis group the intrethecal IgGIF, IgG index and IgG synthesis rate of 24 hours were 31.25% (11.65%-71.45 %), 0.93% (0.80%-1.04%), 24.25 mg/24 h(15.25-46.15 mg/24 h) ,the results were all higher than that in control group (D=175.5, 112.5,103.4,P<0.05). And in multiple sclerosis group there was no significant difference among the intrethecal IgGIF, IgG index and IgG synthesis rate of 24 hours, the positive rate of oligaclonal bands (P>0.05). In disease control group(80 patients) QALB Was 35.2×10-3[(18.5-55.5)×10-3] ,the result was significantly higher than control group (D=102.7, P<0.05), the oligaclonal bands were all negative, IgG index and IgG synthesis rate of 24 hours were 0.75(0.69-0.82) ,44.29 mg/24 h(20.35-65.98 mg/24 h) were both higher than control group(D=85.6,98.5,P<0.05). In disease control group the positive rate of intrathecal IgGIF, IgG index and IgG synthesis rate of 24 hours were 0 (0/80), 40.0% (32/80), 72.5% (58/80) respectively, IgG index and its positive rate both increased alone with the lesion degree of blood-brain barrier increasing (P<0.05). And there was similar trend in the IgG synthesis rate of 24 hours. There were significant correlations among intrathecal IgGIF, IgG index and IgG synthesis rate of 24 hours in multiple sclerosis group (r=0.788, 0.695 ,P<0.05). However there was no correlation among intrathecal IgGIF, IgG index and IgG synthesis rate of 24 hours in disease control group (r=0.000,P>0.05). Conclusions The Protis software can be used to analyze the intrathecal IgGIF and reflect the actual status of intrathecal IgG synthesis more accurately. Protis software has great application value for clinical diagnosis for nervous system disease.