儿童多发性硬化的临床特征及治疗随访  

Clinical features and treatment effects in children with multiple sclerosis

作　　者：朱近[1] 张玉琴[1] 李鸿[1] 于晓莉[1] 李东[1] 张培元[1] 叶露梅[1] 

机构地区：[1]天津市儿童医院,天津300074

出　　处：《临床儿科杂志》2009年第8期761-763,共3页Journal of Clinical Pediatrics

摘　　要：目的探讨儿童多发性硬化(multiple sclerosis,MS)的临床特征及治疗效果,以提高诊治水平。方法回顾分析15例儿童多发性硬化患儿的临床特征及治疗随访情况。结果15例多发性硬化患儿中,男8例,女7例;急性和亚急性起病14例(93.3%);起病年龄为2.5岁～11岁,平均(7.43±2.83)岁;其中复发-缓解型12例,继发-进展型3例。常见首发症状为视力下降9例(60.0%),共济失调6例(40.0%),肢体瘫痪6例(40.0%)。11例患儿行MRI检查,均异常,5例显示空间多发。9例患儿长期随访2年3个月～16年,均有3～7次复发。结论儿童多发性硬化发病率明显低于成人,起病年龄多在10岁以下,以视神经受累多见,强化MRI检查对MS的诊断极为重要;急性期应用激素及静脉丙种球蛋白治疗有效。objectives To improve diagnosis and treatment of multiple sclerosis （MS） by analyzing the characteristics of clinical presentation, magnetic resonance imaging （MRI） and outcome in children with MS. Methods The medical records of 15 MS patients were analyzed by retrospective analysis. Results 15 MS patients （12 relapsing-remitting cases and 3 secondary-progressive cases） were included. 14 of 15 cases （93.3%） were acute or sub-acute onset. There were 8 males and 7 females and mean age at the time of diagnosis was （7.4 3±2.83） year （from 2.5 years to 11 years）. Motor symptoms more often presented in patients with impaired vision （60.0%, 9/15）, ataxia （40.0%, 6/15）, paralysis （40.0%, 6/15）. MRI showed typical multifocal lesions in 5 cases. Three to seven times of recurrence were developed in each of nine MS patients who have been followed up from 2 years to 16 years. Conclusions Incidence of childhood MS is much less than that of adults, and the diagnosing age is younger than 10 years old. Their initial presentation is optic neuritis. Enhanced MRI is a significant method for diagnosing MS. Glucocorticoids and Gammavenin showed a definite effect on childhood MS during acute phase.

关 键 词：儿童 多发性硬化 激素 磁共振 

分 类 号：R744.51[医药卫生—神经病学与精神病学]