| Cerebrospinal fluid is the important port which can reflect nervous system disease, the variation of ingredient of CSF is often used to diagnose nervous system disease and observe curative effect and judge prognosis by clinic. The detection methods commonly used of CSF at present cannot satisfy the demand of diagnosis and differential diagnosis to nervous system disease clinically. The recent investigations reveal that the qualitative and quantitative examination of protein conduced to the diagnosis of nervous system disease, especially the quantitative examination of albumen (Alb) and immunoglobulin (Ig).Alb is the protein marker of blood brain barrier (BBB) function. The impact of that the increase of Alb in blood which can cause the increase of Alb in CSF can be obviated through the detection of albumin quotient (QAlb), therefore the QAlb is deemed to be the ideal index which can reflect BBB function. The recent investigations reveal that distinct etiological factor lead to different degree of injury of BBB, QAlb not only can reflect the severity of disease but also can hint the property of disease accordingly. Previous study was merely limited to quantitative research of Ig in CSF. However, the quantity of Ig in CSF was influenced by the quantity of Ig in blood and the osmosis of BBB which cannot reflect the source of Ig in CSF exactly. The recent investigations reveal that Ig intrathecal synthesis is the pathologic foundation of some autoimmunity nervous system disease, and the type of the Ig intrathecal synthesis relate to the property of disease.137 hospital patients with various neurological disorders and 28 controls without neurological disorders were enrolled into this study. Albumin (Alb) and Immunoglobulin (IgG, IgA and IgM) in CSF and in serum were measured in the same time with diffused light immunoturbidimetry. The QAlb, QIg and IgG index were calculated and the results were analyzed by"Reibergrams"method. BBB dysfunction and intrathecal Ig synthesis were determined. To investigate if there are any clinical application value in detecting albumin (Alb) and Immunoglobulin (IgG, IgA and IgM) by analyzing the degree of injury of BBB and the type of intrathecal Ig synthesis in different nervous system disease.Results: 1,QAlb17.11×10-3 was often seen in isolated BBB dysfunction group, QAlb11.76×10-3 was often seen in the group had both BBB dysfunction and intrathecal Ig, QAlb in the two group compared with control group P<0.05, QAlb4.29×10-3 was often seen in isolated intrathecal Ig synthesis group compared with control group P>0.05; 2,the result of QIgG,QIgA,QIgM in isolated BBB dysfunction group,the group had both BBB dysfunction and intrathecal Ig and isolated intrathecal Ig synthesis group compared with control group P<0.05; 3,when IgG index was above 0.68, there often was intrathecal Ig synthesis and the group compared with control group P<0.05; 4,QAlb in the differential diagnosis to different CNS disease: brain tumor (23.11×10-3) >cerebrovascular disease (13.55×10-3) >CNS infectious diseases (8.45×10-3); QAlb in the differential diagnosis to the etiopathogenisis of meningitis: cerebral tuberculosis (18.22×10-3) >purulent meningitis (10.30×10-3) >viral meningitis (5.88×10-3) ; compared in interclass P<0.05.Conclusions: 1,QAlb is the significance level in judging BBB dysfunction. And with the QAlb level increasing, the degree of BBB dysfunction aggravated. Moreover, the QAlb conduce to make the differential diagnosis of different CNS disease and the etiopathogenisis of meningitis. 2,QIg is the significance level in judging intrathecal Ig synthesis, but it often was influenced by BBB dysfunction. However, IgG index is better index than QIg. 3,Intrathecal IgA and IgM synthesis was mainly seen in CNS infectious diseases; Intrathecal IgA or IgM synthesis was mainly seen in cerebrovascular disease; Intrathecal IgM synthesis was mainly seen in brain tumor. There were different degree of IgM or IgA,IgM Intrathecal synthesis in meningitis, but IgA Intrathecal synthesis was only seen in cerebral tuberculosis. The Ig intrathecal synthesis type was different in various nervous system diseases, so it can be used to make the differential diagnosis to CNS disease.New ideas in this study:1,BBB dysfunction and intrathecal Ig synthesis was determined by"Reibergrams"method, and it was used to make the differential diagnosis to CNS disease. 2,In nervous system diseases,with the QAlb level increasing, the degree of BBB dysfunction aggravated. Moreover, the QAlb conduce to make the differential diagnosis of different CNS disease and the etiopathogenisis of meningitis.3,The Ig intrathecal synthesis type was different in various nervous system diseases, so it can be used to make the differential diagnosis to CNS disease. |
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