脑脊液寡克隆区带、24小时鞘内IgG合成率及IgG指数在脑脊膜血管型神经梅毒诊断中的应用研究

目的 探讨脑脊液寡克隆区带、24 h鞘内IgG合成率及IgG指数在脑脊膜血管型神经梅毒诊断中的应用价值。方法 回顾性分析2014年6月-2019年6月于首都医科大学附属北京地坛医院神经内科连续住院的脑脊膜血管型神经梅毒患者的临床资料，对脑脊液甲苯胺红不加热血清试验（toluidine red unheatedserum test，TRUST）、寡克隆区带、24 h鞘内IgG合成率及IgG指数诊断脑脊膜血管型神经梅毒的阳性率和假阴性率进行分析。结果 研究共纳入确诊的脑脊膜血管型神经梅毒患者102例。脑脊液寡克隆区带、24 h鞘内IgG合成率及IgG指数检查的阳性率分别为93.1%、93.1%和91.2%，均高于TRUST检查的阳性率（71.6%，均P＜0.001）。脑脊液寡克隆区带、24 h鞘内IgG合成率及IgG指数检查的假阴性率分别为6.9%、6.9%及8.8%，均低于TRUST检查（28.4%，均P＜0.001）。结论 脑脊液寡克隆区带、24 h鞘内IgG合成率及IgG指数均可用于脑脊膜血管型神经梅毒的诊断，且上述指标的敏感性和假阴性率均优于脑脊液TRUST检测。

Application of Cerebrospinal Fluid Oligoclonal Bands, 24-hour Intrathecal IgG Synthesis Rate and IgG Index in#br#the Diagnosis of Meningovascular Syphilis#br#

Objective To investigate the value of cerebrospinal fluid (CSF) oligoclonal bands, 24-hourintrathecal IgG synthesis rate and IgG index in the diagnosis of meningovascular syphilis.Methods Clinical data of patients with meningovascular syphilis hospitalised in the Departmentof Neurology, Beijing Ditan Hospital, Capital Medical University from June 2014 to June 2019were retrospectively analyzed, and the positive (abnormal) rate, false negative rate of CSFTRUST,oligoclonal bands, 24-hour intrathecal IgG synthesis rate and IgG index in patients withmeningovascular syphilis were analyzed.Results A total of 102 patients with meningovascular syphilis were enrolled. The positive(abnormal) rates of CSF oligoclonal bands, 24-hour intrathecal IgG synthesis rate and IgG indexwere 93.1%, 93.1% and 91.2%, respectively, which were all significantly higher than that of TRUST(71.6%) (all P <0.001). The false negative rates of CSF oligoclonal bands, 24-hour intrathecal IgGsynthesis rate and IgG index were 6.9%, 6.9% and 8.8%, respectively, which were all lower thanthat of CSF-TRUST (28.4%) (all P <0.001).Conclusions The CSF oligoclonal bands, 24-hour intrathecal IgG synthesis rate and IgG index canbe used in the diagnosis of meningovascular syphilis, and the sensitivity and false negative rates of