51例苏州地区多发性硬化患者的临床特征及预后影响因素分析  

Analysis of clinical characteristics and prognostic factors of 51 patients with multiple sclerosis in Suzhou area

作　　者：乔本玉 吴小珂[1] 宋文丽 李科儒 李后德 蒋雨 张金茹 徐晓东[1] 陈冬勤 曹勇军[1] 张艳林[1] QIAO Benyu;WU Xiaoke;SONG Wenli;LI Keru;LI Houde;JIANG Yu;ZHANG Jinru;XU Xiaodong;CHEN Dongqin;CAO Yongjun;ZHANG Yanlin(Department of Neurology,the Second Affiliated Hospital of Soochow University,Suzhou 215000,China;Department of Neurology,Lianyungang Hospital of Traditional Chinese Medicine,Lianyungang 222004,China)

机构地区：[1]苏州大学附属第二医院神经内科,苏州215000 [2]连云港市中医院神经内科,连云港222004

出　　处：《中国免疫学杂志》2025年第3期680-685,共6页Chinese Journal of Immunology

摘　　要：目的:探讨苏州地区多发性硬化(MS)患者的临床特点,分析影响其预后的主要因素。方法:回顾性分析2009年7月31日至2021年7月31日入住苏州大学附属第二医院神经内科的51例MS患者一般资料、临床症状及脑脊液、影像学检查,并探讨影响其预后的主要因素。结果:51例MS患者平均发病年龄(43.3±15.6)岁,女性占56.9%,男/女=1/1.3。成人MS(AOMS)占62.8%,男/女=1/1.7;晚发型MS(LOMS)占37.2%,男/女=1/0.9。复发缓解型MS(RRMS)占76.5%,慢性起病占60.8%,年平均复发率8.8%。首发症状多见肢体麻木、无力。确诊MS后未复发者多见头晕、麻木,复发者多见肢体无力、麻木。MRI病灶中,侧脑室旁受累62.7%(32/51),脊髓受累52.9%(27/51),幕下受累51.0%(26/51)。与确诊MS后未复发者相比,复发者幕下、脊髓(颈髓、胸髓)受累比例明显增加。随着复发次数增加,脑脊液白蛋白、IgG、IgA、IgM数值升高。男性EDSS评分较女性高,LOMS评分较AOMS高。MS确诊后未复发患者EDSS评分低,随访时评分为0(0,1.00)分;复发者评分相对偏高,随访时评分为2.75(0.25,7.25)分。结论:MS患者以慢性起病多见,LOMS比例偏高,随着发病年龄增加,男性比例升高。首次发病高EDSS评分,颈髓、胸髓、幕下病灶,脑脊液白蛋白、IgG、IgA、IgM数值升高,首次发病年龄50岁以上,男性与MS不良预后相关。Objective:To explore clinical characteristics of multiple sclerosis(MS)patients in Suzhou,and to analyze main factors affecting their prognosis.Methods:General data,clinical symptoms,cerebrospinal fluid and imaging examinations of 51 MS patients admitted to Department of Neurology of the Second Hospital of Soochow University from July 31,2009 to July 31,2021 were retrospectively analyzed,and main factors affecting their prognosis were discussed.Results:Average age of onset of 51 MS patients was(43.3±15.6)years old,female accounted for 56.9%,male/female=1/1.3.Adult onset MS(AOMS)accounted for 62.8%,male/female=1/1.7;late onset MS(LOMS)accounted for 37.2%,male/female=1/0.9.Relapsing remitting MS(RRMS)accounted for 76.5%,and chronic onset accounted for 60.8%.Average annual recurrence rate was 8.8%.The first symptoms were numbness and weakness of limbs.Dizziness and numbness were more common in patients without recurrence after diagnosis of MS,and limb weakness and numbness were more common in patients with recurrence.Among lesions of MRI,62.7%(32/51)of periventricular involvement,52.9%(27/51)of spinal cord involvement,51.0%(26/51)of infratentorial involvement.Proportion of subtentorial and spinal cord(cervical,thoracic)involved were significantly higher in patients with recurrent MS than without recurrence.Values of albumin,IgG,IgA and IgM in cerebrospinal fluid increased with increase of recurrence times.EDSS score of male was higher than female,and LOMS score was higher than AOMS.MS patients without relapse had a low EDSS score,and median EDSS score at current follow-up was 0(0,1.00)score.MS score with relapse was relatively high,and median EDSS score at current follow-up was 2.75(0.25,7.25)score.Conclusion:MS patients with chronic onset are more common,with a high proportion of LOMS,and proportion of males increases with increasing age of onset.High EDSS score at first onset,cervical,thoracic and subtentorial lesions,increased values of cerebrospinal fluid albumin,IgG,IgA,IgM,age at first onset(50+years old),mal

关 键 词：多发性硬化 预后 晚发 临床特征 

分 类 号：R744.51[医药卫生—神经病学与精神病学]