视神经脊髓炎谱系疾病的临床特点及复发影响因素

发布时间：2018-07-31 13:54

【摘要】：目的:分析水通道蛋白4抗体(AQP4-IgG)阳性与阴性视神经脊髓炎谱系疾病(NMOSD)患者的临床特点及复发影响因素。方法:选取2013年1月至2016年10月于我院神经内科诊治并符合2015年IPND制定的诊断标准的NMOSD患者58例,根据AQP4抗体血清学或脑脊液结果分为AQP4抗体阳性组与AQP4抗体阴性组,采用卡方检验、Mann-Whitney U检验分析两组患者的临床特点,采用重复测量方差分析及多因素Logistic回归分析进行复发及复发相关因素分析。结果:AQP4抗体阳性组和AQP4抗体阴性组在年发作次数、同时累及颈胸髓、脊髓受累≥6节段差异具统计学意义(P0.05)。Logistic回归分析显示AQP4抗体阳性(P=0.000,OR=0.137,95%CI=0.087~0.215)、脊髓受累≥6节段(P=0.000,OR=2.369,95%CI=1.899~2.955)与NMOSD发病1年内复发相关;前驱感染(P=0.013,OR=0.438,95%CI=0.347~0.553)、AQP4抗体阳性(P=0.000,OR=2.103,95%CI=1.648~2.683)、脊髓受累≥6节段(P=0.002,OR=2.620,95%CI=2.090~3.284)与NMOSD发病3年内复发相关。结论:AQP4抗体阳性NMOSD患者年发作次数及脊髓受累≥6节段较阴性患者多,而AQP4抗体阴性患者更易同时累及颈胸髓。AQP4抗体阳性及脊髓受累≥6个节段、前驱感染为预测NMOSD复发的独立危险因素。
[Abstract]:Objective: to analyze the clinical characteristics and recurrence factors of (NMOSD) patients with aquaporin-4 antibody (AQP4-IgG) positive and negative. Methods: from January 2013 to October 2016, 58 NMOSD patients who were diagnosed and treated in our department of neurology from January 2013 to October 2016 and who met the diagnostic criteria established by IPND in 2015 were divided into two groups according to the results of AQP4 antibody serology or cerebrospinal fluid (CSF): AQP4 antibody positive group and AQP4 antibody negative group. The clinical features of the two groups were analyzed by chi-square test and Mann-Whitney U test. Recurrence and recurrence related factors were analyzed by repeated measurement variance analysis and multivariate Logistic regression analysis. Results the number of episodes in the positive group and the negative group of AQP4 antibody were the same as the cervical and thoracic spinal cord at the same time. Logistic regression analysis showed that AQP4 antibody was positive (P < 0. 137) and spinal cord involvement 鈮，

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