多发性硬化患者发生视神经炎34例的回顾性分析

目的:探讨视神经炎与多发性硬化(multiple sclerosis,MS)的相互关系,评价甲基强的松龙对多发性硬化的治疗效果。方法:回顾性分析解放军总医院2000/2005年多发性硬化住院患者85例,所有患者均符合Poser诊断标准,用SPSS软件统计并分析这些患者的临床资料。结果:在85例患者中,出现视神经炎36例(42%),其中20例(24%)以视神经炎为首发症状。对所有辅助检查结果分析后发现,有视神经炎患者头部MRI的异常数(64%)高于无眼部症状患者组(30%)(P<0.05,χ2=6.28);有视神经炎患者颈部MRI的异常数(64%)高于无眼部症状患者组(31%)(P<0.05,χ2=4.87)。经过大剂量甲强龙冲击并丙种球蛋白辅助治疗有59例(69%)症状缓解,18例(21%)病情减轻,有视神经炎36例患者31例视力有所提高。结论:对于首发视力障碍就诊于眼科、诊断为视神经炎的患者,应常规行MRI检查以除外MS,大剂量甲强龙冲击并干扰素或丙种球蛋白辅助治疗是MS首选方式。

Retrospective analysis of optic neuritis among the patients of multiple sclerosis

AIM:To investigate the correlations between optic neuritis and multiple sclerosis(MS),and to estimate the importance of methylprednisolone for multiple sclerosis.METHODS:A total of 85 MS inpatients who were admitted to General Hospital of Chinese PLA from 2001 to 2005 were retrospectively analyzed.All patients conform-ed to Poster standard of diagnosis.SPSS software was employed to analyzed clinical data of these patients.RESULTS:Among 85 patients,36 patients(42%) had optic neuritis and 20 patients(24%) had initial symptom of optic neuritis.The statistical analysis showed that the head MRI positive rate in patients with optic neuritis(64%) was higher than that in patients without ocular symptoms(30%)(P<0.05,χ2=6.28);the neck MRI positive rate in patients with optic neuritis(64%) was also higher than that in patients without ocular symptoms(31%)(P<0.05,χ2=4.87).Through treat-ment for MS with a large dose of methylprednisolone and gamma globulin,the symptoms of 59 cases(69%) were relieved;sufferings of 18 cases(21%) were alleviated;the visual acuity of 31 cases among 36 patients with optic neuritis was improved.CONCLUSION:When patients with optic neuritis visit the department of ophthalmology,they should have a conventional MRI to exclude MS.A large dose of methylprednisolone and gamma globulin for MS is the first choice.