罗家明;王莉;柯莎;周晶;余巨明;秦新月;

• 1:川北医学院附属医院神经内科
• 2:重庆医科大学附属第一医院神经内科

摘要(Abstract)：

目的探讨临床孤立综合征(clinically isolated syndromes,CIS)转归为多发性硬化(multiple sclerosis,MS)和视神脊髓炎(neuromyelitis optica,NMO)的影响因素。方法收集CIS患者106例,据CIS转归结果分为MS组、NMO组和未转归组,以同年龄段健康体检人群100名作为健康对照,分析比较各组之间血清尿酸(uric acid,UA)和同型半胱氨酸(homocysteine,HCY)水平,以多因素回归分析方法分析CIS类型、年龄、性别、病灶数量、影像学特点、扩展的神经功能障碍评分(expanded disability status scale,EDSS)评分、HCY水平、UA水平、治疗是否使用糖皮质激素等因素与CIS转归为MS或NMO的关系。结果总体转归为MS共18例(16.98%),转归为NMO共38例(35.85%)。MS组〔(316.26±186.76)μmol/L〕与NMO组〔(323.95±218.64)μmol/L〕UA水平低于未转归组〔(495.22±259.57)μmol/L〕和健康对照组〔(581.34±283.88)μmol/L〕(P<0.05),MS组与NMO组比较,以及未转归组与健康对照组比较差异均无统计学意义(P≥0.05)。MS组HCY水平〔(21.30±12.92)μmol/L〕高于NMO组〔(9.65±4.31)μmol/L〕、未转归组〔(11.40±5.87)μmol/L〕及健康对照组〔(10.86±4.91)μmol/L〕(均P<0.05),NMO组、未转归组及健康对照组HCY水平差异无统计学意义(P≥0.05)。多因素回归分析结果提示女性(OR=8.945,P=0.043)、多病灶(OR=6.681,P=0.000)、EDSS评分高于平均值(OR=8.451,P=0.000)与和HCY水平高于平均值(OR=7.839,P=0.000)是CIS易于转归为MS的影响因素,而多病灶(OR=6.947,P=0.000)、UA水平低于平均值(OR=1.368,P=0.024)、初次发作EDSS评分高于平均值(OR=9.002,P=0.000)是CIS易于为NMO的影响因素。结论女性患者、多病灶特点、高HCY水平、EDSS评分高对CIS转归为MS有预测价值;多病灶特点、低血UA水平、EDSS评分高对CIS转归为NMO有预测价值。

关键词(KeyWords)： 临床孤立综合征;多发性硬化;视神经脊髓炎;尿酸;同型半胱氨酸

Abstract:

Keywords:

基金项目(Foundation): 四川省卫生厅资助项目(110305)

作者(Author): 罗家明;王莉;柯莎;周晶;余巨明;秦新月;

Email:

DOI:

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