特发性脱髓鞘性视神经炎复发的相关因素临床分析

发布时间：2018-01-22 19:11

  本文关键词： 特发性脱髓鞘性视神经炎 复发 转归 激素剂量 双眼视神经炎　出处：《广西医科大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的：分析引起特发性脱髓鞘性视神经炎(IDON)复发的可能因素,为预防复发提供依据。 方法：采用回顾性研究的方法,收集广西医科大学第一附属医院在2003年1月至2011年1月间确诊为特发性脱髓鞘性视神经炎住院患者的相关资料,并对其进行随访追踪,了解其复发与复发有关的因素,观察截止日期是2012年1月,对可能引起复发的原因进行单因素和多因素的分析。 结果：本研究最后纳入115例特发性脱髓鞘性神经炎的患者,随访发现复发32例,未复发83例。单因素分析结果显示年龄(P=0.453)、患眼初次最佳矫正视力(logMAR)(P=0.962)、性别(P=0.091)、眼痛(P=0.398)、视盘水肿(P=0.098)、激素剂量(P=0.128)、初发病时是否脱髓鞘(P=0.082)与IDON复发在统计学上无关,单双眼(P=0.001)和最后转归(P0.001)与IDON复发有关。将上述P0.2的指标经多因素分析显示,IDON的复发与最后转归、单双眼、激素剂量有关,其中IDON的患者转归为脱髓鞘改变的复发率是40.74%,多发性硬化(MS)为70.00%,视神经脊髓炎(NMO)为88.89%,均明显高于不明原因组8.70%(P≤0.001),单眼ON复发率高达40.00%,明显高于双眼ON复发率12.00%(P=0.009),治疗激素剂量为基因效应组的复发率是42.11%,而非基因效应组为25.00%(P=0.045)。 结论：最后转归、单双眼和激素剂量是影响IDON复发的重要因素。复发视神经炎(ON)可作为转归为MS和NMO的强烈预测因子,应对此类病患做好疾病的科普宣教,重视定期复查及随访。同时进一步证实了单眼ON与双眼ON存在差异,应对两者分开研究。
[Abstract]:Objective: to analyze the possible factors causing the recurrence of idiopathic demyelinating optic neuritis (IDON) and to provide evidence for the prevention of recurrence. Methods: the data of the inpatients with idiopathic demyelinating optic neuritis from January 2003 to January 2011 in the first affiliated Hospital of Guangxi Medical University were collected by retrospective study. It was followed up to find out the factors related to recurrence and the deadline of observation was January 2012. The possible causes of recurrence were analyzed by univariate and multi-factor analysis. Results: a total of 115 patients with idiopathic demyelinating neuritis were enrolled in this study. 32 cases of recurrence and 83 cases of non-recurrence were found at follow-up. The results of univariate analysis showed that age was 0.453). The first best corrected visual acuity (BCVA) of the affected eyes was 0.962D, gender was 0.091g, eye pain was 0.398g, edema of optic disc was 0.098). There was no statistically significant correlation between the hormone dose of 0.128 and whether or not demyelinating P0. 082 at the beginning of onset of IDON recurrence. P0. 001) and P0. 001) were associated with the recurrence of IDON. The multivariate analysis showed the recurrence and final outcome of P0. 2. The recurrence rate of IDON was 40.74 and that of multiple sclerosis was 70.00%. The NMO of optic neuromyelitis was 88.89, which was significantly higher than that of unexplained group (P 鈮，

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