两种多发性硬化诊断标准的比较

目的 针对诊断多发性硬化（MS）的McDonald标准、Poser标准的有效性做比较。方法 按中枢神经系统（CNS）受累的临床表现将35例MS患者分为脊髓型和非脊髓型两个亚组，并对部分患者进行了随访观察，用卡方检验对两种诊断标准进行比较分析。结果 两种诊断标准对脊髓型、非脊髓型MS的诊断阳性率接近（P＞0．05），但McDonald标准中诊断不能的例数相对较多（P＜0．05），经随访观察均证实为MS。结论 Poser标准对MS诊断的有效性优于McDonald标准，但对其在诊断进展型MS时的MS时的病程规定有待于进行改良或者灵活运用。MS诊断的有效性优于McDonald标准，但对其在诊断进展型MS时的病程规定有待于进行改良或者灵活运用。

The Comparison of Two Diagnostic Criteria of Multiple Sclerosis

Objective The comparison was made for the validity of the diagnostic criteria between McDonald's and Poser's.Methods According to the clinical manifestation of the central nervous system(CNS) involved, 35 cases of multiple sclerosis (MS) were divided into spinal type and non spinal type subgroups,accompanied by follow up observation upon some MS patients. Chi square test was adopted to compare and analyze the two diagnostic criteria.Results The positive diagnosis rate of spinal type MS or non spinal type MS between Poser criterion and McDonald criterion were generally equal(P>0 05).However, the case number out of accord with McDonald criterion was relatively more than Poser criterion, which were comfirmed as MS by follow up observation.Conclusions Poser criterion is superior to McDonald criterion in the validity of the diagnosis for MS. But it need improving or used in a flexible way in defining the duration of progressive MS.