基于2015年版诊断标准的视神经脊髓炎谱系疾病临床与影像学特征分析

发布时间：2018-03-30 13:13

  本文选题：视神经脊髓炎　切入点：水通道蛋白质　出处：《中国现代神经疾病杂志》2016年09期

【摘要】：目的基于2015年版视神经脊髓炎谱系疾病诊断标准,探讨血清NMO-IgG阳性和阴性患者临床和影像学特征。方法回顾分析96例视神经脊髓炎谱系疾病患者(包括NMO-IgG阳性64例、NMO-Ig G阴性32例)的临床和影像学表现。结果 NMO-IgG阳性和阴性患者首次发病均以脊髓受累常见,发生率分别为48.44%(31/64)和56.25%(18/32),其中感觉障碍(肢体麻木)发生率最高。NMO-IgG阳性组首发视神经受累症状以单侧视力下降常见(12/16)、NMO-IgG阴性组以双侧视力下降常见(6/9),NMO-IgG阳性组最后区受累的顽固性呃逆、呕吐症状较NMO-IgG阴性组多见(11/18对2/7),组间差异均无统计学意义(P=0.087,0.202)。两组患者首次发病时脊髓病灶均以颈髓常见[41.67%(15/36)和11/17],NMO-IgG阳性组颈髓-胸髓连续病灶发生率[41.67%(15/36)对1/17]和病灶≥7个椎体节段比例[36.11%(13/36)对1/17]均高于NMO-Ig G阴性组(P=0.008,0.022),而颅内病灶发生率[90.63%(29/32)对14/17]和延髓-颈髓连续病灶发生率(6/11对1/2)组间差异无统计学意义(P=0.702,1.000)。两组患者病程中脊髓病灶发生率[84.38%(54/64)对84.38%(27/32)]、延髓-颈髓连续病灶发生率(9/19对3/6)和颅内病灶发生率[86.54%(45/52)对83.33%(25/30)]差异均无统计学意义(P=1.000,1.000,0.934)。结论基于2015年版诊断标准分析我国血清NMO-IgG阳性和阴性的视神经脊髓炎谱系疾病患者的临床和影像学特征,有助于进一步提高疾病的诊断与治疗水平。
[Abstract]:Objective based on the 2015 edition of the diagnostic criteria of optic neuromyelitis pedigree disease, To investigate the clinical and imaging features of serum NMO-IgG positive and negative patients. Methods the clinical and imaging features of 96 patients with optic neuromyelitis spectrum disease (including 64 NMO-IgG positive patients with NMO-Ig G negative) were retrospectively analyzed. Results NMO-IgG was performed. Spinal cord involvement is common in both positive and negative patients. The incidence rates were 48.4441 / 64) and 56.25m / 18 / 32, respectively. The incidence of sensory disorders (limb numbness) was the highest. The first onset of optic nerve involvement was unilateral visual acuity decline in 12 / 16 / 16 / NMO-IgG negative group, and 6 / 9NMO-IgG positive group had 6 / 9 / 9NMO-IgG positive group. Vomiting symptoms were 11 / 18 vs 2 / 7 in the NMO-IgG negative group, and there was no significant difference between the two groups. The cervical spinal cord lesions were common in the two groups at the first onset [41.675 / 36) and 11 / 17] NMO-IgG positive group, the incidence of continuous cervical and thoracic spinal cord lesions [41.67b 1536] and 鈮，

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