东北地区204例多发性硬化患者临床特征分析

目的 总结东北地区多发性硬化(MS)的临床特点.方法 对204例MS患者的临床表现、病变部位、影像学特点、实验室检查及激素治疗进行分析总结.结果 (1)性别:男69例(33.82％),女135例(66.18％);发病年龄:20 ～40岁95例(46.57％).(2)起病形式:急性或亚急性为主(65.69％),25例患者(12.25％)首次发病前存在明显诱因.(3)常见症状:肢体无力为主(70.59％),尿便障碍56例(27.45％);以复发-缓解型多见.(4)脑脊液IgG增高占60.19％;脑干视、听觉诱发电位阳性率为69.77％;体感诱发电位阳性率为2.94％.(5)病灶部位:脑部异常73例(35.78％),脊髓异常53例(25.98％),脑与脊髓均有病灶78例(38.24％).(6)均无MS家族史,自身免疫性疾病史者8例,3例为产后发病.(7)150例患者接受激素治疗,并采用扩展残疾状态量表(Expanded disability status scale,EDSS)评价其疗效,有效率为78.67％.结论 我国北方地区MS患者仍以女性为多;发病年龄以20～40岁为主;临床特点表现为发病较晚、起病急,以复发-缓解型为主;大多数患者发病前无明显诱因;神经系统症状以肢体运动及感觉障碍为主,尿便障碍较常见;本组患者颅内病灶主要见于皮质下白质、侧脑室旁及半卵圆中心,小脑受累较少;脊髓病灶主要以颈段受累为主;激素冲击治疗对本组患者有较好疗效.

Analysis of the clinical features in 204 cases of multiple sclerosis in Northeast China

Objective To analysis the clinical features of multiple sclerosis(MS)in Northeast China.Methods We performed a retrospective clinical review include the manifestations,location of lesions,features of imaging,laboratory examination and treatment of 204 MS cases.Results(1)Of 204 cases(69 male and 135 female),95 cases(46.57%)aged from 20 to 40.(2)The onset of the disease was mostly acute or subacute(65.69%),and 25 cases(12.25%)had an inducement.(3)Paralysis(70.59%)was the most common nervous symptoms.56 cases(27.45%)had urinary or boweldy dysfunction.(4)The IgG of cerebrospinal fluid was increased in 62 cases(60.19%,n=103),43 cases had the visual and auditory evoked potential examination of brainstem and 69.77% were positive,34 cases had the somatosensory evoked potential examination and 2.94% were positive.5.73 cases(35.78%)with only brain lesions,followed by the spinal cords 53 cases(25.98%),and both brain and spinal cord involvement in 78 cases(38.24%).6.Family history of MS was not found in 204 cases.8 cases had autoimmune disease and 3 cases fell ill after postpartum.7.150 cases accepted treatment of hormone.The treatment effects were assessed using the expanded disability status scale(EDSS),and 78.67% were effective.Conclusion MS in Northeast China mainly invaded female who aged from 20 to 40 years.The clinical features of MS including that the onset age was later,the episode was more urgent,and elapsing-remitting MS accounted for most of the disease type.Most of cases had not inductive factors.The nervous symptoms were mainly dyskinesia and sensory disturbance.And the urinary or boweldy dysfunction was common.The MS lesions of brain were commonly involved subcortical white matter,the white matter around lateral ventricle,and semioval center,while cerebellum was seldom involved.The cervical spinal cords were easily involved.Steroid therapy has proved to be effective in the treatment of MS.