中华医学会神经病学分会神经免疫学组

通信作者： 施福东

执笔金薇娜（国家神经系统疾病临床医学研究中心）、郑培（首都医科大学附属北京天坛医院）

【摘要】
中枢神经系统自身免疫性疾病是以自身免疫细胞、自身抗体及其他免疫分子直接或间接攻击神经系统（包括神经元、胶质细胞、髓鞘）为主要致病机制的自身免疫性疾病。这一类疾病的早期鉴别诊断、疾病进展监测以及疗效预后评估等很大程度上依赖于实验室辅助检查。而国内中枢神经系统自身抗体检测方法学的选择和判读依据尚缺乏适合的标准或指导性规范，迫切需要规范实验室诊断以更好地指导临床实践。为此，中华医学会神经病学分会神经免疫学组基于国内外抗体检测技术进展和临床诊断需求，并在充分征求学组专家意见的基础上形成了“中枢神经系统自身免疫性疾病相关抗体检测专家共识2022”。本共识总结常见的中枢神经系统自身免疫性疾病（以中枢神经系统炎性脱髓鞘疾病和自身免疫性脑炎为例）实验室辅助检查的原理和传统检测方法，对如何选择实验检查项目以及解读实验室检查的结果给出指导性建议。

【关键词】
中枢神经系统；自身免疫疾病；自身抗体；实验室；诊断；共识

Expert consensus on the detection of antibodies associated with autoimmune diseases of the central nervous system 2022

Chinese Society of Neuroimmunology
Corresponding author: Fu‑Dong Shi, Center of Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China, Email: [email protected]

【Abstract】

Autoimmune diseases of central nervous system are mainly caused by the direct or indirect attack of autoimmune cells and inflammatory factors on the nervous system (including neurons, glial cells and myelin sheath). The early differential diagnosis, monitoring of disease progression, and evaluation of curative effect and prognosis of these diseases are largely dependent on laboratory‑assisted examination. At present, it is an urgent need to standardize laboratory diagnosis to better guide the clinical diagnosis and treatment of autoimmune disease of the central nervous system in China. To this end, Chinese Society of Neuroimmunology edits the "Expert consensus on the detection of antibodies associated with autoimmune diseases of the central nervous system 2022". This consensus summarized the principle, traditional detection methods, how to select experimental examination items combined with clinical, and how to interpret the results of laboratory examination for common central nervous system immune diseases (Take demyelinating disease of central nervous system and autoimmune encephalitis for example).

【Key words】

Central nervous system; Autoimmune diseases; Autoantibodies; Laboratories; Diagnosis; Consensus

Conflicts of interest: None declared

中枢神经系统（central nervous system，CNS）自身免疫性疾病种类繁杂，包括视 神经脊髓炎谱系疾病 （neuromyelitis optic spectrum disorder，NMOSD）、髓鞘少突胶质细胞糖蛋白抗体相关疾病（myelinoligodendrocyte glycoprotein-IgG associated disorders，MOGAD）、多发性硬化（multiple sclerosis，MS）、 急性播散性脑脊髓炎 （acute disseminated encephalomyelitis，ADEM）、自身免疫性脑炎（autoimmune encephalitis，AE）、CNS血管炎等，发病机制复杂，自身免疫细胞、自身抗体及其他免疫分子直接或间接攻击神经系统引起的免疫炎性反应在其发病过程中起着重要作用。其中，自身抗体在自身免疫性脑炎和CNS炎性脱髓鞘疾病的诊断与鉴别诊断中起着非常重要的作用，而这两大类疾病在CNS自身免疫性疾病中又相对常见，因此，我们主要对CNS炎性脱髓鞘疾病和自身免疫性脑炎的抗体检测给出指导性建议。