多发性硬化和视神经脊髓炎高危综合征患者的早期临床特点对比观察  

Comparative Study on the Clinical Features of Patients with Early Multiple Sclerosis and High-risk Syndrome of Neuromyelitis Optica

作　　者：杨成蓉[1] 杨志刚[1] 

机构地区：[1]雅安市人民医院神经内科,四川雅安625000

出　　处：《医学综述》2015年第6期1151-1152,共2页Medical Recapitulate

摘　　要：目的对比观察早期多发性硬化和视神经脊髓炎(NMO)高危综合征患者的临床特点。方法选择2011年1月至2013年1月雅安市人民医院接诊的45例早期多发性硬化患者和45例NMO高危综合征患者进行研究,分别定义为多发性硬化组和NMO组。对比分析两组患者的一般资料状况、疾病首发症状以及磁共振成像、脑脊液状况,进而比较两种疾病的临床特点。结果两组均以女性患者为主,多发性硬化组患者的复发次数显著少于NMO组[(2.3±2.0)次比(4.2±3.2)次,P<0.05]。多发性硬化组感觉异常的发生率显著高于NMO组,两组比较差异有统计学意义(42.2%比20.0%,P<0.05)。多发性硬化组患者复视、视力下降的发生率均显著低于NMO组,两组比较差异有统计学意义(2.2%比15.6%,20.0%比42.2%,P<0.05)。多发性硬化组患者的脑MRI多发性硬化病灶数量超过9个的发生率显著高于NMO组(77.8%比0%)(P<0.01)。患者中脊髓病灶(14例,31.1%)、脑脊液白细胞计数异常(15例,33.3%)、脑脊液蛋白异常(18例,40.0%)的发生率均显著低于NMO组(31例,68.9%;27例,60.0%;28例,62.2%),差异有统计学意义(P<0.05)。结论早期多发性硬化和NMO高危综合征患者存在着许多不同的临床特点,可用于两种疾病的早期鉴别诊断。Objective To compare the clinical features of patients with early multiple sclerosis and high-risk syndrome of neuromyelitis optica（ NMO）. Methods A total of 45 patients with early multiple sclerosis and another 45 patients with high-risk syndrome of NMO admitted in Ya＇an People＇s Hospital from Jan.2011 to Jan. 2013 were selected as multiple sclerosis group and NMO group. General condition of the patients,the first symptom of the disease,as well as MRI,cerebrospinal fluid situation of the two groups were analyzed,in order to compare the clinical characteristics of the two diseases. Results Patients in the two groups were mainly female,the frequency of relapse of the multiple sclerosis group was significantly less than the NMO group [（ 2. 3 ± 2. 0） times vs（ 4. 2 ± 3. 2） times,P〈0. 05]. The incidence of abnormal feeling of the multiple sclerosis group was significantly higher than NMO group,the difference was statistically significant（ 42. 2% vs 20. 0%,P〈0. 05）. Incidences of diplopia and impaired vision of the multiple sclerosis group were significantly lower than NMO group,the differences were statistically significant（ 2. 2% vs15. 6%,20. 0% vs 42. 2%,P〈0. 05）. Incidence of over nine lesions appeared in brain MRI of patients with multiple sclerosis was significantly higher than NMO group（ 77. 8% vs 0%）（ P〈0. 01）. In multiple sclerosis group,incidences of spinal cord lesions（ 14 cases,31. 1%）,abnormal white blood cell count in cerebrospinal fluid（ 15 cases,33. 3%）,and abnormal protein level in cerebrospinal fluid（ 18 cases,40. 0%）were significantly lower than those of NMO group（ 31 cases,68. 9%; 27 cases,60. 0%; 28 cases,62. 2%）,the differences were statistically significant（ P〈0. 05）. Conclusion Patients with early multiple sclerosis and high-risk syndrome of NMO have many different clinical characteristics,which can be used in early differential diagnosis of the two diseases.

关 键 词：早期多发性硬化 视神经脊髓炎 临床特点 

分 类 号：R744[医药卫生—神经病学与精神病学] R774.6[医药卫生—临床医学]