季节及纬度与多发性硬化发病的关系  

The relationship between season/latitude and multiple sclerosis

作　　者：马佳[2] 张星虎[1] 

机构地区：[1]北京市顺义区医院神经内科,101300 [2]首都医科大学附属北京天坛医院神经内科,100050

出　　处：《中华内科杂志》2015年第11期945-948,共4页Chinese Journal of Internal Medicine

摘　　要：目的通过观察多发性硬化（MS）患者发病／复发的季节及纬度分布特点，分析季节及纬度对MS的影响。方法回顾性分析2002年1月—2012年12月首都医科大学附属北京天坛医院神经内科264例住院MS患者的资料，其中男88例，女176例，发病／复发共453例次。统计4个季节MS复发情况的差异；选取一个维度跨度较小的地区（北京地区）的MS患者，分析各个月份的发病／复发例次与该月份的平均气温、日光照射强度及照射时间的相关性；以北京市纬度范围（39．39°N～41．07°N）的中位数（40．22°N）为分界线，将MS患者分为高纬度组和低纬度组，比较两组的性别分布、发病年龄、病程及复发情况。结果4个季节中冬季的发病／复发例次最多（134例次），夏季的发病／复发例次最少（97例次）。同一纬度（北京地区）患者的发病／复发人数与该地区的平均气温、阳光照射强度呈负相关（r=-0．699，P=0．006；r=-0．623，P=0．015）。高纬度组复发率为68．7％（123／179），高于低纬度组的63．0％（51／81），P=0．000；而两组的性别分布、发病年龄、病程的差异均无统计学意义。结论MS发病／复发有明显的季节分布特征，且与纬度有关。MS发病／复发与患者居住地的气温、阳光照射强度有关。环境因素是MS发病／复发的一个重要诱因，其中阳光照射最为关键。Objective To explore the impact of season and latitude on multiple sclerosis by study the onset/relapse season and latitude distribution in multiple sclerosis （MS） patients.Methods A total of 264 MS patients , with 88 males and 176 females, who were hospitalized in Beijing Tiantan Hospital from January 2002 to December 2012, were enrolled in the study and all the clinical data were retrospectively analyzed.The mean age was （33.9 ± 12.3） years old, with the disease duration of （6.3 ±4.5） years and 453 cases of relapse.The recurrence of MS was collected by four seasons, with March to May defined as spring, June to August as summer, September to November as autumn and December to February as winter.MS patients lived in Beijing （39.39＆#176; N-41.07＆#176; N） were chosen to test the correlation between the incidence/recurrence and monthly mean temperature, sunlight exposure intensity and duration.All the patients were divided into the high latitude group and the low latitude group, taken the latitude median （40.22＆#176; N） of Beijing area as the boundary.Gender composition, age of onset, disease duration and recurrence rate were compared between the two groups.Results Most of the onset/ relapse of MS were observed in winter （134 cases）, while summer （97 cases） took the least.In the same latitude region （Beijing area）, the onset/ relapse of MS was negatively correlated to the mean temperature and sunlight exposure intensity （r =-0.699, P =0.006;r =-0.623, P =0.015）.Recurrence was higher in the high latitude group than in the low latitude group [68.7% （123/179） vs 63.0% （51/81）, P =0.000], while no significant difference was found in gender composition, age of onset and disease duration between the two groups.Conclusion The onset/recurrence of MS has obvious seasonal characteristics.The onset/recurrence of MS is correlated with latitude, temperature and sunlight exposure intensity of the habitation of MS patients.Environmental factors are important cause of the onset/re

关 键 词：多发性硬化 复发 季节 纬度 环境因素 

分 类 号：R744.51[医药卫生—神经病学与精神病学]