CAJ | 학술논문

目的观察复发性视神经炎的临床特点以及自身免疫抗体(水通道蛋白4抗体和血清抗核抗体)的分布.方法收集2010年10月至2012年4月间在解放军总医院神经眼科住院诊治的复发性视神经炎患者54例的临床资料,回顾分析其一般临床特点,统计其水通道蛋白4抗体(AQP4-Ab)(36例)和血清抗核抗体(ANAs)的阳性率,并与相关文献数据分析比较.结果男女比例1∶2.6,发病年龄平均30.3岁；病程50d～20年,发病次数2～8次.病程中最差视力(矫正后)在0.1以下者44例,占81.5％.ANAs阳性率22.2％ (12/54),AQP4-Ab阳性率27.8％ (10/36)；颅脑和/或脊髓核磁异常者占48.0％ (24/50)；脑脊液异常70.0％ (16/23).结论复发性视神经炎多发于青壮年,视力损害较重,自身免疫抗体(AQP4-Ab和ANAs)阳性率较视神经脊髓炎及复发性长节段横贯性脊髓炎略低,中枢神经系统影像检查对其诊治有重要价值.
목적 관찰복발성시신경염적림상특점이급자신면역항체(수통도단백4항체화혈청항핵항체)적분포.방법 수집2010년10월지2012년4월간재해방군총의원신경안과주원진치적복발성시신경염환자54례적림상자료,회고분석기일반림상특점,통계기수통도단백4항체(AQP4-Ab)(36례)화혈청항핵항체(ANAs)적양성솔,병여상관문헌수거분석비교.결과 남녀비례1∶2.6,발병년령평균30.3세；병정50d～20년,발병차수2～8차.병정중최차시력(교정후)재0.1이하자44례,점81.5％.ANAs양성솔22.2％ (12/54),AQP4-Ab양성솔27.8％ (10/36)；로뇌화/혹척수핵자이상자점48.0％ (24/50)；뇌척액이상70.0％ (16/23).결론 복발성시신경염다발우청장년,시력손해교중,자신면역항체(AQP4-Ab화ANAs)양성솔교시신경척수염급복발성장절단횡관성척수염략저,중추신경계통영상검사대기진치유중요개치.
ObJective To investigate the clinical features and seroprevalence of autoimmune antibodies (aquaporin-4 antibodies,AQP4-Ab and antinuclear antibodies,ANAs) in patients with recurrent optic neuritis (RON).Methods Fifty-four RON patients who were in-hospital in Ophthalmology Department of PLA from October 2010 to April 2012 were enrolled in the study.The general clinical features and statistic the positive rate of AQP4-Ab and ANAs were analyzed retrospectively,and the relative data in other studies were compared.Results The ratio of male to female was 1:2.6 and the average age of onset was 30.3 years old.The recurrent attacks of optic neuritis were 2 to 8 times during 50 days to 20 years.There were 44 patients (81.5％) who had ever appeared the lowest visual acuity (corrected) of ＜0.1 in the course of disease.The rate of seropositive ANAs was 22.2％ (12/54) while 27.8％ (10/36) for AQP4-Ab.The 48.0％ (24/50) cases were abnormal in Brain and/or spinal cord MRI and 70.0％ (16/23) in CSF.Conclusions RON is more appeared in youth with poor visual acuity.The positive rate of AQP4-Ab and ANAs are lower than neuromyelitis optica (NMO) and recurrent longitudinally extensive transverse myelitis (r-LETM).The MRI of central nervous system posses important value for diagnosis and treatment of RON.