放射学孤立综合征转归危险因素及临床管理的研究进展  

Research progress on risk factors for radiologically isolated syndrome conversion and its clinical management

作　　者：贾燕 赵代弟 李宏增 郭俊 Jia Yan;Zhao Daidi;Li Hongzeng;Guo Jun(Department of Neurology,the Second Affiliated Hospital,Air Force Medical University,Xi′an 710038,China)

机构地区：[1]空军军医大学第二附属医院神经内科,西安710038

出　　处：《中华神经科杂志》2023年第5期578-582,共5页Chinese Journal of Neurology

基　　金：国家自然科学基金面上项目(82171339);陕西省重点研发计划(2022ZDLSF02-04)。

摘　　要：放射学孤立综合征被认为是多发性硬化前驱期的影像学标志,约有1/3的患者在确诊后5年内转归为临床孤立综合征或明确的多发性硬化。放射学孤立综合征是否需要启动疾病修饰治疗迄今尚无定论,但有效识别转归的危险因素对于早期筛查高危患者和后续的临床精准管理大有裨益。文中结合国内外最新研究进展,从人口学特征、临床表现、影像学、脑脊液和眼科学检查等方面总结了放射学孤立综合征向多发性硬化转归的危险因素。由于放射学孤立综合征的疾病修饰治疗仍处于临床试验阶段,尚无明确的推荐意见,文中从临床监测、药物治疗和预防疾病进展等方面进行详细阐述,旨在为疾病的临床管理提供思路。Radiologically isolated syndrome(RIS)is considered as an imaging marker of the prodromal stage of multiple sclerosis(MS),and approximately one-third of patients might convert to clinically isolated syndrome or clinically definite multiple sclerosis within 5 years after diagnosis.Although it still remains inconclusive whether or not disease-modifying therapies for RIS need to be initiated,effective identification of prognostic factors for conversion would be of great benefit for early screening of high-risk patients and subsequent clinical precision management.Combined with the latest research progress at home and abroad,this review summarizes the prognostic factors for conversion of RIS to MS from the aspects of demographic characteristics,clinical presentations,imaging manifestations,cerebrospinal fluid and ophthalmological examinations.Given that disease-modifying therapies for RIS are still in clinical research stage and there are no definite recommendations to date,this article expounds the research progress on clinical monitoring,therapeutics and prevention of disease progression,which aims to provide neurologists with reference suggestions on clinical management of RIS.

关 键 词：放射学孤立综合征 多发性硬化 临床孤立综合征 疾病管理 

分 类 号：R744.51[医药卫生—神经病学与精神病学]