多发性硬化患者起病年龄与寡克隆区带电泳分型的关系

doi:10.3969/j.issn.1673-8640.2026.10.005

摘要/Abstract

摘要：

目的探讨多发性硬化（MS）患者起病年龄与寡克隆区带电泳（OCB）分型的关系，初步揭示不同起病年龄MS患者OCB的分型特征。方法选取2021年1月—2025年1月首都医科大学宣武医院MS患者225例，将205例成年起病患者分为青年起病（18~<40岁）组（157例）和中老年起病（≥40岁）组（48例）。收集所有患者的临床资料，并检测脑脊液白蛋白（Alb）、IgG和血清Alb、IgG水平，以及OCB分型，计算24 h鞘内合成率（简称24 h-IgG）、脑脊液白蛋白商值（Q_Alb）、IgG指数。结果 205例成年起病MS患者中，有76例为18~29岁起病、81例为30~39岁起病、40例为40~49岁起病、7例为50~59岁起病、60~69岁起病1例；OCB阳性（Ⅱ型+Ⅲ型）144例、阴性（Ⅰ型）61例，无Ⅳ型或Ⅴ型。中老年起病组OCB阳性率低于青年起病组（P<0.001）。青年起病组血清Alb水平高于中老年起病组（P<0.001），脑脊液Alb水平和Q_Alb低于中老年起病组（P<0.01），24 h-IgG、IgG指数、脑脊液IgG、血清IgG 2个组之间差异均无统计学意义（P>0.05）。结论 MS起病年龄集中于19~49岁。青年起病的MS患者OCB阳性率、血清Alb水平均高于中老年起病患者，而Q_Alb、脑脊液Alb水平低于中老年起病MS患者。以上指标可为晚发型MS的实验室诊断和分层管理提供参考。

关键词: 多发性硬化, 起病年龄, 寡克隆区带电泳

Abstract:

Objective To investigate the relationship between the onset ages of multiple sclerosis（MS） patients and the electrophoretic typing of oligoclonal bands（OCB），and to preliminarily reveal the typing characteristics of OCB in MS patients with different onset ages. Methods Totally，225 MS patients from Xuanwu Hospital of Capital Medical University from January 2021 to January 2025 were enrolled. Among them，205 patients with onset at adulthood were classified into young-onset group（18-<40 years old）（157 cases） and middle-aged and elderly-onset group（≥40 years old）（48 cases）. The clinical data were collected，and the levels of cerebrospinal fluid albumin（Alb），IgG and serum Alb，IgG，as well as OCB typing were determined. The 24-hour intrathecal synthesis rate（referred to as 24 h-IgG），cerebrospinal fluid albumin quotient（Q_Alb） and IgG index were calculated. Results Totally，205 cases were adult-onset patients. There were 76 cases with onset between 18 and 29 years old，81 cases between 30 and 39 years old，40 cases between 40 and 49 years old，7 cases between 50 and 59 years old，and 1 case between 60 and 69 years old. OCB was positive in 144 cases（type Ⅱ + type Ⅲ） and negative in 61 cases（type Ⅰ）. There was no type Ⅳ or type Ⅴ. The positive rate of OCB in the middle-aged and elderly-onset group was lower than that in the young-onset group（P<0.001）. The serum Alb level in the young-onset group was higher than that in the middle-aged and elderly-onset group（P<0.001），and the cerebrospinal fluid Alb level and Q_Alb were lower than those in the middle-aged and elderly-onset group（P<0.01）. There was no statistical significance in 24 h-IgG，IgG index，cerebrospinal fluid IgG and serum IgG between the 2 groups（P>0.05）. Conclusions The onset age of MS is concentrated in the range of 19-49 years. The OCB positive rate and serum Alb level of young-onset MS patients are higher than those of middle-aged and elderly-onset patients，while the Q_Alb and cerebrospinal fluid Alb levels are lower than those of middle-aged and elderly-onset patients. This provides a reference for the laboratory diagnosis and stratified management of late-onset MS.

Key words: Multiple sclerosis, Onset age, Oligoclonal band electrophoresis

中图分类号:

R446.61

王一丹, 付静轩, 曹敬荣, 王培昌. 多发性硬化患者起病年龄与寡克隆区带电泳分型的关系[J]. 检验医学, 2026, 41(10): 961-965.

WANG Yidan, FU Jingxuan, CAO Jingrong, WANG Peichang. Relationship between the age of onset in multiple sclerosis patients and the electrophoretic typing of oligoclonal bands[J]. Laboratory Medicine, 2026, 41(10): 961-965.

图/表 5

参考文献 14

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部位	例数	百分比/%
幕上病灶
半卵圆中心	103	50.2
顶叶	63	30.7
额叶	52	25.4
胼胝体	27	13.2
基底节区	23	11.2
颞叶	21	10.2
皮层/近皮层	22	10.7
枕叶	10	4.9
幕下病灶
脑桥	51	24.9
小脑	35	17.1
丘脑	24	11.7
延髓	17	8.3
中脑	15	7.3
脊髓病灶
胸髓	39	19.0
腰髓	37	18.0
颈髓	28	13.7
其他
视神经	34	16.6

部位	例数	百分比/%
幕上病灶
半卵圆中心	103	50.2
顶叶	63	30.7
额叶	52	25.4
胼胝体	27	13.2
基底节区	23	11.2
颞叶	21	10.2
皮层/近皮层	22	10.7
枕叶	10	4.9
幕下病灶
脑桥	51	24.9
小脑	35	17.1
丘脑	24	11.7
延髓	17	8.3
中脑	15	7.3
脊髓病灶
胸髓	39	19.0
腰髓	37	18.0
颈髓	28	13.7
其他
视神经	34	16.6

组别	例数	年龄/岁	起病年龄/岁	性别		BMI/（ kg·m^-2）
组别	例数	年龄/岁	起病年龄/岁	男/[例（%）]	女/[例（%）]	BMI/（ kg·m^-2）
青年起病组	157	34（28，38）	30（25，34）	53（33.8）	104（66.2）	21.63（19.88，24.80）
中老年起病组	48	50（47，57）	45（43，49）	17（35.4）	31（64.6）	23.41（21.43，24.90）
统计值		9.256	10.483	0.045		2.233
P值		<0.001	<0.001	0.832		0.026

组别	例数	年龄/岁	起病年龄/岁	性别		BMI/（ kg·m^-2）
组别	例数	年龄/岁	起病年龄/岁	男/[例（%）]	女/[例（%）]	BMI/（ kg·m^-2）
青年起病组	157	34（28，38）	30（25，34）	53（33.8）	104（66.2）	21.63（19.88，24.80）
中老年起病组	48	50（47，57）	45（43，49）	17（35.4）	31（64.6）	23.41（21.43，24.90）
统计值		9.256	10.483	0.045		2.233
P值		<0.001	<0.001	0.832		0.026

组别	例数	阴性（Ⅰ型）/ [例（%）]	阳性（Ⅱ型+Ⅲ型）/[例（%）]
青年起病组	157	37（23.6）	120（76.4）
中老年起病组	48	24（50.0）	24（50.0）
χ²值		12.29
P值		<0.001