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The AQP-4 Antibody Detection and Clinical Analysis of Optic Spinal Nerve Demyelination Disease Spectrum

Author: ZhaoChunXia
Tutor: ZhangMeiNi
School: Shanxi Medical
Course: Neurology
Keywords: Word Neuromyelitis Optic nerve multiple sclerosis Multiple sclerosis AQP-4 antibody
CLC: R744.52
Type: Master's thesis
Year: 2011
Downloads: 30
Quote: 0
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Abstract


Background neuromyelitis optica (NMO) is a successively or simultaneously involving the optic nerve and spinal cord acute or subacute, with a single-phase or multiphase course of clinical inflammatory demyelinating disease of the central nervous system. Neuromyelitis multiple sclerosis (OSMS), also known as multiple sclerosis in Asia, previously considered to be a subtype of multiple sclerosis (MS), and in recent years he and traditional Western-type MS (CMS) study found that in the natural course of the disease, clinical manifestations, imaging features, treatment and prognosis are many ways there are differences, and with the discovery of AQP-4 antibody confirmed it is independent of the MS disease unit. In Japan AQP-4 antibody positive the OSMS patients almost there a long segmental extensive spinal cord lesions (LESCLs), it is considered AQP-4 antibody plays an important role in the progression of the extensive spinal cord damage OSMS patients. But there are also about 1/4 of the classic MS in Asian LESCLs, AQP-4 antibody formation in the Asian MS subtypes LESCLs in the role as well as of OSMS with the NMO's still not very clear, and rare domestic research in this regard. Qualitative detection of AQP-4 antibody indirect immunofluorescence method, observation of clinical features of AQP-4 antibodies with central nervous system demyelinating disease; further elucidate the importance of AQP-4 autoantibody detection in the entire optic nerve spinal cord disease spectrum and OSMS explore the relations between NMO and MS; provide valuable and easy detection of laboratory indicators for early diagnosis, differential diagnosis and prognosis. Collected in July 2009 - December Shanxi Medical University Hospital, Department of Neurology, inpatient and outpatient clinical diagnosis of central nervous system demyelinating disease, 65 patients, the patients were in disease exacerbation. Extraction study fasting venous blood, centrifuged to extract serum stored at -80 ℃ refrigerator spare. And patients extended disability (EDSS) score, head and spinal cord MRI enhancement or T 1 , T2, FLAIR sequence detection. Take the green indirect immunofluorescence assay serum AQP-4 antibody. AQP-4 antibody with the group of diseases related to the clinical features, analysis of AQP-4 antibody sensitivity and specificity for the diagnosis of NMO and OSMS. AQP-4 antibody detection sensitivity and specificity in the the NMO group of patients. Were 66.7% and 93.9%, AQP-4 antibody detection of OSMS sensitivity and specificity were 64.7% and 93.9%, respectively. The OSMS (64.71%) group and NMO (66.67%), group patients serum AQP-4 antibody positive rate was significantly higher than MS (6%) group and the the OSMS group of patients positive for AQP-4 are spinal cord lesions greater than 3 spinal cord paragraph long and extensive damage in patients. And NMO and OSMS disease group AQP-4 antibody positive rate group difference was not statistically significant (P gt; 0.05); the OSMS patients at the age of onset, MRI examination, EDSS scores NMO extremely similar. Conclusion NMO, OSMS with MS in many ways there are differences in the natural course of the disease and clinical features. Indirect immunofluorescence assay serum AQP-4 antibody simple, have a higher sensitivity and specificity in the diagnosis of NMO and OSMS help identify with MS. However, due to the presence of a high degree of heterogeneity OSMS patients MRI spinal cord damage, so does not transform a to OSMS simple classified in NMO or MS.

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CLC: > Medicine, health > Neurology and psychiatry > Neurology > Spinal cord disease > Demyelinating disease > Neuromyelitis
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