中国人视神经脊髓炎谱系疾病及多发性硬化与妊娠的相关性

发布时间：2018-06-20 03:47

本文选题：视神经脊髓炎谱系疾病 + 多发性硬化　；参考：《中山大学学报(医学科学版)》2017年02期

【摘要】：【目的】分析国人视神经脊髓炎谱系疾病(NMOSD)和多发性硬化(MS)与妊娠相关性的异同,以及与妊娠的相互作用。【方法】前瞻性收集235例NMOSD和125例MS患者临床资料,包括年复发率(ARR)、病残程度(EDSS)以及妊娠结局等,筛选出目标病例NMOSD组70例和MS组30例,并纳入50例同期正常妊娠妇女作为对照组,比较分析NMOSD、MS患者在妊娠前1年、中、后1年ARR、EDSS评分变化情况,对比分析3组妊娠结局的差异。【结果】NMOSD和MS首发症状出现在妊娠中或分娩/流产1年内的比率分别分53.25%(41/77)和20.00%(7/35),两者之间有显著差异(P=0.001);NMOSD和MS在产后0~3月ARR(2.65,2.51)显著高于妊娠前1年(0.27,0.49,P0.001)及妊娠中(0.32,0.20,P0.001),且产后1年EDSS(3.06±2.16,2.19±1.28)显著高于妊娠前1年(1.58±0.48,1.92±1.29,P0.001)及妊娠中(1.92±1.35,1.67±0.70,P0.001),但NMOSD和MS两组之间ARR及EDSS评分无差异;NMOSD、MS与正常对照组妊娠结局及新生儿体质量无差异。【结论】与MS相比,NMOSD发病与妊娠相关性更加显著;NMOSD和MS患者分娩及流产均可能增加疾病复发风险并加重疾病残疾,而疾病本身不影响妊娠结局。
[Abstract]:[objective] to analyze the similarities and differences between optic neuromyelitis (NMOSD) and multiple sclerosis (MS) and pregnancy in Chinese. [methods] Clinical data of 235 NMOSD and 125 MS patients were collected prospectively. Among them, 70 cases of NMOSD group and 30 cases of MS group were selected as target cases, and 50 normal pregnant women were included as control group. After one year, the changes of ARRN EDSS score, [results] the rates of initial symptoms of NMOSD and MS in pregnancy or delivery / abortion within one year were 53.2541 / 77) and 20.00 / 735, respectively. There was a significant difference between the two groups. There was significant difference between NMOSD and MS in the period of 0 ~ 3 months postpartum ARR2.655 / 2.51). In the first year before pregnancy, the EDSS score was 3.06 卤2.16 卤2.19 卤1.28) significantly higher than that in the first year before pregnancy (1.58 卤0.481.92 卤1.29 P0.001) and in pregnancy (1.92 卤1.351.67 卤0.70) P0.001a, but there was no difference in ARR and EDSS scores between NMOSD and MS groups and normal control group. There was no significant difference in ARR and EDSS scores between NMOSD and MS groups. [conclusion] compared with MS, the incidence of NMOSD is significantly correlated with pregnancy. Delivery and abortion in NMOSD and MS patients may increase the risk of disease recurrence and aggravate disease disability. The disease itself does not affect the outcome of pregnancy.
【作者单位】：中山大学附属第三医院神经科;肇庆市第二人民医院神经科;中山大学附属第三医院产科;
【基金】：国家自然科学基金(81471218) 广东省自然科学基金(2014A030313014) 广东省科技计划项目(2013B051000037)
【分类号】：R714;R744.5

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