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目的探讨中枢神经系统疾病血脑屏障(BBB)的完整性和鞘内免疫球蛋白合成的意义。方法将研究对象分为8组(A组为10例正常对照组,B组为10例化脓性脑膜炎患者,C组为10例结核性脑膜炎患者,D组为20例病毒性脑(膜)炎患者,E组为8例脱髓鞘疾病患者,F组为10例格林巴利综合症患者,G组为10例蛛网膜下腔出血和脑出血患者,H组为14例缺血性脑血管病患者),采用速率散射比浊方法测定血清和CSF的白蛋白(Alb)和免疫球蛋白(IgG、IgMI、gA)含量,利用公式计算QAlbI、gG指数、IgG合成率,并用Protis软件进行数据和图形处理分析。结果 (1)各组QAlb异常率均较正常对照组增高,其中B、C、E、G组QAlb明显高于正常对照组(P<0.01);(2)B、C、E、G组IgG指数和IgG合成率较正常对照组明显增高(P<0.05或0.01),其中IgG指数以E组最高,IgG合成率以B、E组最高;(3)经Protis软件分析82例患者,正常35例,单纯BBB功能障碍20例,仅有鞘内合成8例,BBB功能障碍伴有鞘内合成19例。结论通过对CSF中蛋白质组分定量的分析,并利用Protis软件进行数据和图形处理,可以明确中枢神经系统疾病血脑屏障完整性和鞘内免疫球蛋白的合成,以及对某些中枢神经系统疾病的诊断和鉴别诊断具有重要的临床意义。
Objective To investigate the integrity of the blood-brain barrier (BBB) in central nervous system diseases and the significance of intrathecal immunoglobulin synthesis. Methods The subjects were divided into 8 groups (10 normal controls in group A, 10 patients with purulent meningitis in group B, 10 patients with tuberculous meningitis in group C and 20 patients with viral brain in group D ) Patients with inflammation, E group was 8 patients with demyelinating disease, F group was 10 patients with Guillain-Barre syndrome, G group was 10 patients with subarachnoid hemorrhage and cerebral hemorrhage, H group was 14 cases of ischemic (Alb) and immunoglobulin (IgG, IgMI, gA) in serum and CSF were measured by rate nephelometry. QAlbI, gG index and IgG synthesis rate were calculated by the formula, Data and graphics analysis. Results (1) The abnormal rate of QAlb in each group was higher than that in normal control group, and the QAlb in groups B, C, E and G was significantly higher than that in normal control group (P <0.01); (2) (P <0.05 or 0.01). The index of IgG was the highest in group E and the rate of IgG synthesis was the highest in group B and group E. (3) According to the software of Protis, 82 patients were normal and 35 Cases, simple BBB dysfunction in 20 cases, only intrathecal synthesis in 8 cases, BBB dysfunction accompanied by intrathecal synthesis in 19 cases. Conclusions Quantitative analysis of protein components in CSF and the use of Protis software for data and graphics make it possible to determine the integrity of the blood-brain barrier and the synthesis of intrathecal immunoglobulins in central nervous system disorders, as well as in some central nervous system diseases The diagnosis and differential diagnosis have important clinical significance.