CAJ | 학술논문

目的比较早期多发性硬化(MS)和视神经脊髓炎(NMO)高危综合征患者的临床特点差异. 方法回顾性收集广州医科大学附属第二医院神经内科自2004年1月至2013年8月收治的早期MS患者49例和NMO高危综合征患者30例(包括长节段的横贯性脊髓炎22例、复发性视神经炎8例)的临床资料、影像学检查结果、血清中NMO-IgG抗体情况等进行分析和比较. 结果早期MS患者和NMO高危综合征患者的EDSS评分、病程以及感觉症状、脑干症状比例比较差异均有统计学意义(P＜0.05).早期MS组患者中病灶数＞9个的比例(77.6％)高于NMO高危综合征组患者,差异有统计学意义(P＜0.05).NMO高危综合征组患者在脑脊液蛋白异常率(19例,63.3％)、蛋白水平[(0.57±0.45) g/L]以及脑脊液白细胞计数异常率(19例,63.3％)、白细胞计数[中位数为24.317个/mm3 (0～274个)]方面与早期MS患者组比较差异有统计学意义(P＜0.05).10例NMO高危综合征患者中6例长节段横贯性脊髓炎患者NMO-IgG阳性,13例早期MS患者中2例出现阳性反应,阳性率比较差异有统计学意义(P＜0.05). 结论早期MS患者和NMO高危综合症的临床特点明显不同,这些差异对早期鉴别MS与NMO具有一定意义.
목적 비교조기다발성경화(MS)화시신경척수염(NMO)고위종합정환자적림상특점차이. 방법 회고성수집엄주의과대학부속제이의원신경내과자2004년1월지2013년8월수치적조기MS환자49례화NMO고위종합정환자30례(포괄장절단적횡관성척수염22례、복발성시신경염8례)적림상자료、영상학검사결과、혈청중NMO-IgG항체정황등진행분석화비교. 결과 조기MS환자화NMO고위종합정환자적EDSS평분、병정이급감각증상、뇌간증상비례비교차이균유통계학의의(P＜0.05).조기MS조환자중병조수＞9개적비례(77.6％)고우NMO고위종합정조환자,차이유통계학의의(P＜0.05).NMO고위종합정조환자재뇌척액단백이상솔(19례,63.3％)、단백수평[(0.57±0.45) g/L]이급뇌척액백세포계수이상솔(19례,63.3％)、백세포계수[중위수위24.317개/mm3 (0～274개)]방면여조기MS환자조비교차이유통계학의의(P＜0.05).10례NMO고위종합정환자중6례장절단횡관성척수염환자NMO-IgG양성,13례조기MS환자중2례출현양성반응,양성솔비교차이유통계학의의(P＜0.05). 결론 조기MS환자화NMO고위종합증적림상특점명현불동,저사차이대조기감별MS여NMO구유일정의의.
Objective To describe and compare the clinical characteristic of earliest multiple sclerosis (MS) and high-risk syndrome of ophthalmoneuromyelitis (NMO).Methods Forty-nine MS patients and 30 NMO patients (22 with long segment of transverse myelitis and 8 with recurrent optic neuritis),admitted to our hospital from January 2004 to August 2013,were chosen in our study; the clinical and imaging data of these patients were analyzed and compared by retrospective study methods;the NMO-IgG antibody in serum was tested by indirect immunofluorescence assay.Results The Kurtzke expanded disability status scale (EDSS) scores,course of disease,sensory symptoms and brainstem symptoms in patients with earliest MS had obvious difference as compared with those in patients with high-risk syndrome ofNMO (P＜0.05); the ratio of patients having lesions more than 9 in the MS group was significantly higher than that NMO patients (P＜0.05).CSF protein abnormality rate (n=19,63.3％),protein level [(0.57±0.45) g/L],CSF white blood cell count abnormal rate (n=19,63.3％) and white blood cell count [Median 24.317 cells/mm3 (0-274 cells)] in the NMO patients was significantly different as compared with those in the MS patients (P＜0.05).NMO-IgG positive rate in the earliest MS group (2/13) was lower than that in the high-risk syndrome group (6/10),with significant difference (P＜0.05).Conclusion The clinical features in patients with earliest MS and high-risk syndrome of NMO are different,which has significance in the early differential diagnosis of MS and NMO.