视神经脊髓炎患者头部核磁共振及临床特点分析

发布时间：2018-03-06 01:25

本文选题：视神经脊髓炎　切入点：磁共振成像　出处：《吉林大学》2014年硕士论文　论文类型：学位论文

【摘要】：研究目的：（1）以视神经脊髓炎（Neuromyelitis optica,NMO）患者为研究对象，分析NMO患者头部MRI异常率,探讨NMO患者头部MRI病灶分布特点；（2）对比分析NMO患者头部MRI正常与头部MRI异常组的临床特点（性别、发病年龄、首发症状、复发情况、发作期EDSS评分、免疫异常情况、脑脊液特点、NMO-IgG阳性率、脊髓MRI特点）。资料与方法；（1）本研究为回顾性研究，病例来源于2006年11月—2014年1月期间入住吉林大学附属第一医院神经内科的视神经脊髓炎患者。记录患者的性别、发病年龄、首发症状、发作期情况、相关实验室检查、影像学资料。（2）对纳入研究的NMO病例所有临床的资料收集并进行分析，依据NMO患者的头部核磁共振改变，将所有纳入研究病例进行分组，即头部MRI正常组和头部MRI异常组，对两组NMO患者的性别、发病年龄、首发症状、复发情况、发作期EDSS评分、免疫异常情况、脑脊液特点、NMO-IgG阳性率、脊髓MRI特点进行对比分析。（3）采用SPSS17.0软件进行统计分析：服从正态分布的计量资料采用均数标准差描述。非正态分布的计量资料采用中位数(median,M)及区间(range,R)描述。符合正态分布的计量资料采用t检验，非正态分布的计量资料描采用Mann-Whitney U检验，计数资料采用2检验。假设检验均以a=0．05为检验水准。研究结果：（1）40例NMO患者中头部MRI表现异常者21例（52．50％），皮层下、皮髓交界区7（33.33%），位于脑室附近的10例(47.62％)；发生于基底节区6例(28.57％)；发生于脑干9例(42.86％)。（2）头部MRI异常组和头部MRI正常组相比发作期严重程度，合并自身免疫性疾病存在显著性差异（P005）,而在性别、发病年龄、首发症状、复发情况、发作期EDSS评分、脑脊液特点、NMO-IgG阳性率、脊髓MRI病灶分布均无统计学意义（P0.05）。结论：（1）NMO患者头部MRI异常有较高的发生率。（2）头部MRI异常的NMO患者发作期病情较重，，合并自身免疫性疾病多见。
[Abstract]:Objectives of the study:. 1) to analyze the abnormal rate of head MRI in patients with NMO and to investigate the distribution of MRI lesions in the head of patients with NMO. (2) the clinical features (sex, age of onset, initial symptom, recurrence, EDSS score, immune abnormality, cerebrospinal fluid (CSF) positive rate of NMO-IgG and spinal cord MRI were compared and analyzed in NMO patients with normal head MRI and abnormal head MRI. Data and methods; This study is a retrospective study. The patients were admitted to the Department of Neurology of the first affiliated Hospital of Jilin University from November 2006 to January 2014. Related laboratory examination, imaging data. (2) collecting and analyzing all clinical data of NMO patients who were included in the study. According to the changes of head MRI in NMO patients, all cases were grouped into groups, that is, head MRI normal group and head MRI abnormal group. Sex, onset age, initial symptom, recurrence, EDSS score, immune abnormality, cerebrospinal fluid (CSF) positive rate of NMO-IgG and spinal cord MRI were compared between the two groups. (3) using SPSS17.0 software for statistical analysis: the measurement data of normal distribution are described by standard deviation of mean number, those of non-normal distribution are described by median medianum M) and interval range R.The measurement data according to normal distribution are described by t test. The measurement data of non-normal distribution were described by Mann-Whitney U test, and the counting data by 2 tests. Results of the study:. Among the 40 cases of NMO, 21 cases had abnormal MRI manifestations of head (52.50%), 733.33 (subcortical) and 733.33 (5 / 40) were located near the ventricle, 6 cases (6 cases) in basal ganglia and 42.86 (9 cases) in brainstem were located near the ventricle, 10 cases (47.62) were located in the basal ganglia, and 9 cases (42.86) were located in the brain stem in the basal ganglia area (n = 6) and in the brainstem (n = 9). (2) there was a significant difference in severity between head MRI abnormal group and head MRI normal group. There was significant difference in the severity of autoimmune diseases (P005). However, in sex, age of onset, initial symptom, recurrence, EDSS score during attack, there was a significant difference between head MRI abnormal group and head MRI normal group. The positive rate of NMO-IgG in cerebrospinal fluid (CSF) and the distribution of spinal MRI lesions were not statistically significant (P 0.05). Conclusion:. There was a high incidence of head MRI abnormality in patients with NMO. (2) NMO patients with abnormal head MRI were more serious in paroxysm and more complicated with autoimmune diseases.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R744.52

【参考文献】