中国神经免疫学和神经病学杂志
中國神經免疫學和神經病學雜誌
중국신경면역학화신경병학잡지
CHINESE JOURNAL OF NEUROIMMUNOLOGY AND
2014年
6期
381-385
,共5页
邱伟%钟晓南%王小立%李征然%钱结胜%康庄%常艳宇%陆正齐%胡学强
邱偉%鐘曉南%王小立%李徵然%錢結勝%康莊%常豔宇%陸正齊%鬍學彊
구위%종효남%왕소립%리정연%전결성%강장%상염우%륙정제%호학강
多发性硬化%视神经脊髓炎%慢性脑-脊髓静脉功能不全
多髮性硬化%視神經脊髓炎%慢性腦-脊髓靜脈功能不全
다발성경화%시신경척수염%만성뇌-척수정맥공능불전
multiple sclerosis%neuromyelitis optica%chronic cerebrospinal venous insufficiency
目的:本研究探讨我国多发性硬化(MS)和视神经脊髓炎(NMO)患者是否存在慢性脑‐脊髓静脉功能不全(CCSVI)。方法入组MS患者10例、NMO和NMO谱系疾病(NMOSD)患者9例。所有患者均进行无创性颅外静脉超声检查,以观察静脉反流、颈内静脉(IJVs)横径(CSA)绝对值和IJVs的CSA差值。患者如果同意则进一步行选择性静脉血管造影(DSA)检查,观测IJVs和奇静脉(AZY)狭窄程度、跨壁压及侧支循环开放情况。选择年龄匹配的健康体检者20名为对照,均进行无创性超声检查。结果(1)静脉超声检查显示,M S及NMOSD患者出现不同程度IJVs和椎静脉(VVs)反流,10例MS中5例出现左侧IJVs反流;8例患者出现右侧IJVs反流;2例患者出现左侧VVs反流;5例出现右侧VVs反流。NMOSD患者也出现IJVs和VVs反流,但均未达到Zamboni的标准,提示MS患者反流可能更加明显。与对照组(0.226±0.078)比较,MS(0.132±0.146, P=0.028)和NMOSD(0.134±0.077,P=0.007)患者右侧 IJVs 坐位 CSA 缩短。(2)3例缓解‐复发型 MS (RRMS)及2例长节段脊髓炎(LEM)患者进行了静脉DSA 检查,其中1例RRMS(AZY开口处狭窄约75%)及1例LEM患者(AZY开口处狭窄约64%)均出现静脉狭窄及侧支循环开放。结论部分MS患者及NMOSD患者存在经超声及DSA证实的CCSVI。
目的:本研究探討我國多髮性硬化(MS)和視神經脊髓炎(NMO)患者是否存在慢性腦‐脊髓靜脈功能不全(CCSVI)。方法入組MS患者10例、NMO和NMO譜繫疾病(NMOSD)患者9例。所有患者均進行無創性顱外靜脈超聲檢查,以觀察靜脈反流、頸內靜脈(IJVs)橫徑(CSA)絕對值和IJVs的CSA差值。患者如果同意則進一步行選擇性靜脈血管造影(DSA)檢查,觀測IJVs和奇靜脈(AZY)狹窄程度、跨壁壓及側支循環開放情況。選擇年齡匹配的健康體檢者20名為對照,均進行無創性超聲檢查。結果(1)靜脈超聲檢查顯示,M S及NMOSD患者齣現不同程度IJVs和椎靜脈(VVs)反流,10例MS中5例齣現左側IJVs反流;8例患者齣現右側IJVs反流;2例患者齣現左側VVs反流;5例齣現右側VVs反流。NMOSD患者也齣現IJVs和VVs反流,但均未達到Zamboni的標準,提示MS患者反流可能更加明顯。與對照組(0.226±0.078)比較,MS(0.132±0.146, P=0.028)和NMOSD(0.134±0.077,P=0.007)患者右側 IJVs 坐位 CSA 縮短。(2)3例緩解‐複髮型 MS (RRMS)及2例長節段脊髓炎(LEM)患者進行瞭靜脈DSA 檢查,其中1例RRMS(AZY開口處狹窄約75%)及1例LEM患者(AZY開口處狹窄約64%)均齣現靜脈狹窄及側支循環開放。結論部分MS患者及NMOSD患者存在經超聲及DSA證實的CCSVI。
목적:본연구탐토아국다발성경화(MS)화시신경척수염(NMO)환자시부존재만성뇌‐척수정맥공능불전(CCSVI)。방법입조MS환자10례、NMO화NMO보계질병(NMOSD)환자9례。소유환자균진행무창성로외정맥초성검사,이관찰정맥반류、경내정맥(IJVs)횡경(CSA)절대치화IJVs적CSA차치。환자여과동의칙진일보행선택성정맥혈관조영(DSA)검사,관측IJVs화기정맥(AZY)협착정도、과벽압급측지순배개방정황。선택년령필배적건강체검자20명위대조,균진행무창성초성검사。결과(1)정맥초성검사현시,M S급NMOSD환자출현불동정도IJVs화추정맥(VVs)반류,10례MS중5례출현좌측IJVs반류;8례환자출현우측IJVs반류;2례환자출현좌측VVs반류;5례출현우측VVs반류。NMOSD환자야출현IJVs화VVs반류,단균미체도Zamboni적표준,제시MS환자반류가능경가명현。여대조조(0.226±0.078)비교,MS(0.132±0.146, P=0.028)화NMOSD(0.134±0.077,P=0.007)환자우측 IJVs 좌위 CSA 축단。(2)3례완해‐복발형 MS (RRMS)급2례장절단척수염(LEM)환자진행료정맥DSA 검사,기중1례RRMS(AZY개구처협착약75%)급1례LEM환자(AZY개구처협착약64%)균출현정맥협착급측지순배개방。결론부분MS환자급NMOSD환자존재경초성급DSA증실적CCSVI。
Objective Chronic cerebrospinal venous insufficiency (CCSVI) is involved in pathogenetic mechanisms of multiple sclerosis (MS) and other inflammatory demyelinating diseases .However ,CCSVI in MS and neuromyelitis optica (NMO) have not previously been investigated in China .Methods Ten MS patients ,9 NMO (and NMOSD) patients were enrolled .Extracranial venous ultrasonography was taken in all patients . Observation indexes including venous reflux ,cross sectional area (CSA) of internal jugular veins (IJVs) ,and changes in IJVs CSA (△CSA) .In addition ,some of the patients underwent digital subtraction angiography (DSA) to detect stenosis of IJVs and azygous vein (AZY) .Extracranial venous ultrasonography was also taken in 20 age‐match healthy controls . Results (1) Extracranial venous ultrasonography revealed that backstreaming in IJVs and vertebral vein (VVs) were significnatly associated with MS and NMO ,and this association was much more significant in MS than NMO .CSA of IJVs on right‐sidedness in sitting position of MS (P= 0.028) and NMO (P=0.007) patients were obvious descend compared with controls .(2) DSA confirmed that narrow in VVs and collateral circulation were seen in MS and NMO patients .Conclusions Evaluated using ultrasonography and DSA ,this study confirmed CCSVI in some MS and NMO patients .