视神经脊髓炎谱系疾病复发相关因素的临床研究

发布时间：2019-05-07 08:00

【摘要】：目的研究视神经脊髓炎谱系疾病(NMOSD)的复发率及其临床特征,分析多因素与NMOSD复发的相关性。方法分析2009年7月29日~2015年12月31日就诊于本院神经内科确诊73例NMOSD患者的临床、实验室检查及扩展残疾状态量表(EDSS)评分等资料。运用卡方检验、Logistic回归分析等统计学方法分析影响NMOSD复发的危险因素。结果 73例NMSOD患者中,男性12例,女性61例,男女比例约1∶5,首次发病中位年龄38岁。血清水通道蛋白-4抗体(AQP4-Ab)阳性检出率84.9%(62/73),血清其他自身免疫抗体阳性72.6%(53/73),脑脊液(CSF)AQP4-Ab阳性检出率45.1%(23/51),CSF蛋白升高率43.9%(25/57)。有序Logistic回归分析结果显示血清AQP4-Ab(OR=14.5561,95%CI 0.120~2.809)、自身免疫抗体(OR=4.3281,95%CI 0.684~4.673)阳性可能是NMOSD发病3 y内复发的独立危险因素。结论血清AQP4-Ab及其他自身免疫抗体阳性可能与NMOSD发病3 y内复发频次呈正相关。
[Abstract]:Objective to study the recurrence rate of (NMOSD) and its clinical characteristics in patients with optic neuromyelitis and to analyze the correlation between multiple factors and NMOSD recurrence. Methods from July 29, 2009 to December 31, 2015, 73 patients with NMOSD were diagnosed in neurology department of our hospital. The clinical data, laboratory examination and (EDSS) score of extended Disability status scale were analyzed. Chi-square test, Logistic regression analysis and other statistical methods were used to analyze the risk factors of recurrence of NMOSD. Results among the 73 patients with NMSOD, 12 were male and 61 were female. The ratio of male to female was about 1 / 5. The median age of the first onset was 38 years. The positive rate of serum aquaporin-4 antibody (AQP4-Ab), other autoantibodies and cerebrospinal fluid (CSF) AQP4-Ab was 84.9%, 72.6% and 45.1% (23 / 51) respectively, and the positive rate of other autoantibodies in serum and CSF was 72.6% (53 / 73) and 45.1% (23 / 51), respectively. The increasing rate of CSF protein was 43.9% (25 / 57). The results of ordered Logistic regression analysis showed that positive serum AQP4-Ab (OR=14.5561,95%CI 0.120 / 2.809) and autoantibody (OR=4.3281,95%CI 0.684 / 4.673) might be independent risk factors for recurrence of NMOSD within 3 years of onset. Conclusion the positive serum AQP4-Ab and other autoantibodies may be positively correlated with the recurrence frequency within 3 years of onset of NMOSD.
【作者单位】：南方医科大学第三临床医学院;海军总医院神经内科;
【基金】：海军总医院归国人员创新技术项目(GGCX201205) 首都市民健康项目培育(Z151100003915113) 首都临床特色应用研究(Z151100004015005)
【分类号】：R744.52

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