影响急性脊髓炎患者预后的独立危险因素:神经功能缺损程度与MRI或体感诱发电位异常  

Prognosis of patients with acute transverse myelitis affected by independent risk factors:severity of neurological deficits and abnormal imagine of MRI or abnormal somatosensory evoked potential

作　　者：高平[1] 秦绍森[1] 时苗[1] 

机构地区：[1]卫生部北京医院神经内科,北京市100730

出　　处：《中国临床康复》2004年第34期7652-7654,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:研究急性脊髓炎预后的影响因素。方法:对卫生部北京医院1999-01/2003-10收治的48例急性脊髓炎病例的资料进行回顾性分析,根据预后情况将患者分为预后良好组及预后不良组,对可能影响预后的危险因素包括:性别、年龄、病情达高峰时间、神经功能缺损程度、脑脊液细胞数、脑脊液蛋白量、病前感染史、激素资料与否、MRI异常、体感诱发电位(SEP)异常、并发症等在两组之间进行显著性检验,然后将具有显著差异的因素引入多元回归分析。结果:预后良好组27例,预后不良组21例。经统计学分析两组病情达高峰时间[(3.82±1.28)d比(5.62±3.91)d,t=2.151,P=0.033]、神经功能缺损评分[(14.83±3.82)分比(9.52±2.31)分,t=2.054,P=0.025]、病前感染史(56%比24%,t=5.284,P=0.032)、MRI异常(72%比33%,t=6.613,P=0.015)、SEP异常(80%比6%,t=6.723,P=0.005)、激素治疗与否(78%比48%,t=5.961,P=0.026)具有显著差异。经多元回归分析显示神经功能缺损程度(OR=1.68)、MRI异常(OR=0.87)、SEP异常(OR=0.68)具有显著意义。结论:神经功能缺损程度、MRI异常、SEP异常是影响预后的独立危险因素。AIM:To investigate the effective factors of prognosis of acute transverse myelitis(ATM). METHODS:Data of 48 patients with ATM were reviewed retrospectively from Beijing Hospital of Ministry of Health between January 1990 and October 2003.All patients were divided into good prognosis group and poor prognosis group according to the results of prognosis.Risk factor which could affect prognosis possibly were were compared between two groups,including sex, age,onset to peak time, neurological deficits,amount of cerebrospinal fluid, protein of cerebrospinal fluid, history of infection preceding onset,data of hormones or not, abnormal imagine of MRI,abnormal somatosensory evoked potential(SEP) and complications.Those with significant differences between the two groups were analyzed with multiple logistic regression. RESULTS:Twenty seven patients were in good prognosis group and 21 in poor prognosis group.Several risk factors were significant differences between the two groups,such as onset to peak time[(3.82±1.28) days(5.62±3.91) days,t=2.151,P=0.033],neurological deficits[(14.83±3.82),(9.52±2.31) poins,t=2.054,P=0.025],history of infection preceding onset (56%vs 24%, t=5.284,P=0.032),abnormal imagine of MRI (72%vs 33%,t=6.613, P=0.015),abnormal SEP(80%vs 6%,t=6.723,P=0.005), treatment of hormones or not(78%vs 48%,t=5.961, P=0.026).Severity of neurological deficits(OR=1.68)abnormal imagine of MRI (OR=0.87) and abnormal SEP(OR=0.68) were significant differneces. CONCLUSION:The severity of neurological deficits, abnormal imagine of MRI and abnormal SEP are the risk factors which can affect the prognosis.

关 键 词：急性脊髓炎 预后 危险因素 神经功能缺损 MRI异常 体感诱发电位异常 并发症 磁共振成像 

分 类 号：R744.3[医药卫生—神经病学与精神病学]