中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2015年
4期
322-325
,共4页
贾红娟%叶静%赵筱玲%贺菲菲%李坤成%刘亚欧
賈紅娟%葉靜%趙篠玲%賀菲菲%李坤成%劉亞歐
가홍연%협정%조소령%하비비%리곤성%류아구
视神经脊髓炎%高危%首发事件
視神經脊髓炎%高危%首髮事件
시신경척수염%고위%수발사건
Neuromyelitis Optica%High-risk%Index events
目的 分析视神经脊髓炎(NMO)首次发作时脊髓、视神经损害的表现,探讨NMO的首发高危脱髓鞘事件.方法 纳入2010年10月-2012年10月在首都医科大学宣武医院神经内科住院并确诊的51例以脊髓炎或视神经炎为首发事件的NMO病例,收集患者首次脱髓鞘事件的临床表现、脊髓及颅脑MRI检查结果等资料,进行分析.结果 (1)26例(51.0％)NMO病例以脊髓炎为首发事件,其中30.8％ (8/26)为长节段横贯性脊髓炎(LETM),69.2％ (18/26)为非LETM(包括短节段脊髓炎和非横贯性脊髓炎),非LETM比LETM多见;非LETM为首发事件病例的首次治疗后转归好于LETM为首发事件病例(完全恢复的比例13/18比2/8,P＜0.05);与LETM病例相比,非LETM病例脊髓炎复发间隔期短、疾病复发频率高(11.1个月比18.6个月;3次/年比1次/年;P均＜0.05).(2)25例(49.0％)NMO病例以视神经炎为首发事件,24.0％(6/25)为单眼视神经炎,76.0％(19/25)为双眼视神经炎,双眼视神经炎较单眼视神经炎多见;双眼视神经炎病例首次发病的视力损害重于单眼视神经炎病例,首次缓解期持续时间短(P＜0.05).结论 非LETM及双眼视神经炎是NMO在首次发病时最常见的临床高危脱髓鞘事件.
目的 分析視神經脊髓炎(NMO)首次髮作時脊髓、視神經損害的錶現,探討NMO的首髮高危脫髓鞘事件.方法 納入2010年10月-2012年10月在首都醫科大學宣武醫院神經內科住院併確診的51例以脊髓炎或視神經炎為首髮事件的NMO病例,收集患者首次脫髓鞘事件的臨床錶現、脊髓及顱腦MRI檢查結果等資料,進行分析.結果 (1)26例(51.0％)NMO病例以脊髓炎為首髮事件,其中30.8％ (8/26)為長節段橫貫性脊髓炎(LETM),69.2％ (18/26)為非LETM(包括短節段脊髓炎和非橫貫性脊髓炎),非LETM比LETM多見;非LETM為首髮事件病例的首次治療後轉歸好于LETM為首髮事件病例(完全恢複的比例13/18比2/8,P＜0.05);與LETM病例相比,非LETM病例脊髓炎複髮間隔期短、疾病複髮頻率高(11.1箇月比18.6箇月;3次/年比1次/年;P均＜0.05).(2)25例(49.0％)NMO病例以視神經炎為首髮事件,24.0％(6/25)為單眼視神經炎,76.0％(19/25)為雙眼視神經炎,雙眼視神經炎較單眼視神經炎多見;雙眼視神經炎病例首次髮病的視力損害重于單眼視神經炎病例,首次緩解期持續時間短(P＜0.05).結論 非LETM及雙眼視神經炎是NMO在首次髮病時最常見的臨床高危脫髓鞘事件.
목적 분석시신경척수염(NMO)수차발작시척수、시신경손해적표현,탐토NMO적수발고위탈수초사건.방법 납입2010년10월-2012년10월재수도의과대학선무의원신경내과주원병학진적51례이척수염혹시신경염위수발사건적NMO병례,수집환자수차탈수초사건적림상표현、척수급로뇌MRI검사결과등자료,진행분석.결과 (1)26례(51.0％)NMO병례이척수염위수발사건,기중30.8％ (8/26)위장절단횡관성척수염(LETM),69.2％ (18/26)위비LETM(포괄단절단척수염화비횡관성척수염),비LETM비LETM다견;비LETM위수발사건병례적수차치료후전귀호우LETM위수발사건병례(완전회복적비례13/18비2/8,P＜0.05);여LETM병례상비,비LETM병례척수염복발간격기단、질병복발빈솔고(11.1개월비18.6개월;3차/년비1차/년;P균＜0.05).(2)25례(49.0％)NMO병례이시신경염위수발사건,24.0％(6/25)위단안시신경염,76.0％(19/25)위쌍안시신경염,쌍안시신경염교단안시신경염다견;쌍안시신경염병례수차발병적시력손해중우단안시신경염병례,수차완해기지속시간단(P＜0.05).결론 비LETM급쌍안시신경염시NMO재수차발병시최상견적림상고위탈수초사건.
Objective To explore the clinical characteristics of the lesions of spinal cord and optic nerve as the onset of neuromyelitis optica (NMO).Methods A total of fifty-one patients with myelitis or optic neuritis (ON) as the onset of NMO who hospitalized in our Neurology Department during October 2010 to October 2012 were enrolled in the study.Clinical presentations and MRI findings of the spinal cord and brain were studied.Results (1) A total of 26 cases (51.0％) presented with myelitis as the index event,in which 30.8％ (8/26) were the longitudinally extensive transverse myelitis (LETM) and 69.2％ (18/ 26) were non-LETM (short segmental myelitis or non-transverse myelitis).Patients with non-LETM as the onset were found to have better prognosis than those with LETM (full recovery ratio was 13/18 vs 2/8,P ＜ 0.05),while shorter recurrence interval of myelitis and higher recurrence frequency of events were shown in patients with non-LETM (11.1 vs 18.6 months,3 times per year vs once per year,with all P ＜ 0.05).(2) A total of 25 cases (49.0％) presented with ON as the index event with 24.0％ (6/25) of unilateral ON and 76.0％ (19/25) of bilateral ON.Patients with bilateral ON had more severe visual impairment and shorter first remission period than those with unilateral ON (P ＜ 0.05).Conclusion Non-LETM and bilateral ON are the most common index demyelinating events in NMO cases.
