视神经脊髓炎谱系疾病预后的相关性分析  

Correlation analysis of prognosis in neuromyelitis optic spectrum diseases

作　　者：赵娜[1,2] 沙晶 玛依努尔·买买提[1,2] 李红燕 ZHAO Na;SHA Jing;Mayinur Maimaiti;LI Hongyan(People’s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China;Xinjiang Clinical Research Center for Stroke and Neurological Rare Disease,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院,新疆乌鲁木齐830001 [2]新疆脑卒中与神经系统罕见病临床医学研究中心,新疆乌鲁木齐830001

出　　处：《中国实用神经疾病杂志》2023年第11期1365-1369,共5页Chinese Journal of Practical Nervous Diseases

基　　金：新疆维吾尔自治区自然科学基金资助项目(编号:2019D01C150);新疆维吾尔自治区人民医院科技引进创新项目(编号:20200108)。

摘　　要：目的分析视神经脊髓炎谱系疾病(NMOSD)患者预后与脑脊液白细胞、免疫球蛋白(Ig)、白蛋白、寡克隆区带(OCB)、IgG指数的相关性。方法回顾性选取2019-01—2022-01新疆维吾尔自治区人民医院收治的50例NMOSD患者,根据预后进行分组,50例NMOSD患者复发29例,纳入复发组,21例未复发者则纳入未复发组。比较2组患者人口学特征资料、临床表现、影像学资料、脑脊液生化资料。结果单因素分析结果显示复发组、未复发组年龄[(38.71±6.53)岁比(45.62±7.28)岁]、MRI示脊髓累及节段[(6.12±1.38)个比(5.22±1.23)个]、白细胞[(5.02±0.46)×109个/L比(5.32±0.52)×109个/L]、白蛋白[(0.59±0.11)g/L比(0.51±0.14)g/L]、IgG[(13.65±1.88)μmol/L比(12.54±1.79)μmol/L]、OCB阳性(6例比0例)、IgG指数(0.97±0.12比0.86±0.14)差异有统计学意义(P<0.05)。多因素Logistic分析显示年龄大是NMOSD复发的保护因素(P<0.05),MRI示脊髓累及节段多、IgG指数大是NMOSD复发的危险因素(P<0.05)。结论NMOSD患者复发率高,其预后与年龄、MRI示脊髓累及节段、IgG指数密切相关。Objective To analyze the correlation between the prognosis of patients with neuromyelitis optica spectrum disorder(NMOSD)and cerebrospinal fluid leukocytes,immunoglobulins(Ig),albumin,oligoclonal bands(OCB)and IgG index.Methods A total of 50 patients with NMOSD admitted to People’s Hospital of Xinjiang Uygur Autonomous Region from January 2019 to January 2022 were reviewed.They were divided into the recurrence group(29 cases)and non-recurrence group(21 cases)according to the prognosis.Demographic characteristics,clinical manifestations,imaging data,and cerebrospinal fluid biochemical data of the two groups were comparatively analyzed.Results Univariate analysis found that there were statistically significant differences between the recurrence group and the non-recurrence group in terms of age[(38.71±6.53)years old vs(45.62±7.28)years old],the number of involved spinal cord segments displayed by MRI(6.12±1.38 vs 5.22±1.23),leukocyte count[(5.02±0.46)×109/L vs(5.32±0.52)×109/L],albumin level[(0.59±0.11)g/L vs(0.51±0.14)g/L],IgG level[(13.65±1.88)μmol/L vs(12.54±1.79)μmol/L],the number of OCB positive cases(6 vs 0),and IgG index(0.97±0.12 vs 0.86±0.14)(P<0.05).Multivariate Logistic analysis results showed that Practical Nervous Diseases Nov.2023,Vol.26 No.11 advanced age was a protective factor for the recurrence of NMOSD(P<0.05).Multiple spinal cord segments involved displayed by MRI and high IgG index were risk factors for the recurrence of NMOSD(P<0.05).Conclusion The recurrence rate of NMOSD is high.The prognosis is closely related to age,MRI findings of spinal cord involvement,and IgG index.

关 键 词：视神经脊髓炎谱系疾病 预后 脑脊液 生化指标 寡克隆区带 IGG指数 

分 类 号：R744.52[医药卫生—神经病学与精神病学]