多发性硬化与引起顽固性呃逆、呕吐的视神经脊髓炎特征分析

目的探讨引起顽固性呃逆、呕吐的视神经脊髓炎与多发性硬化的临床特征,为疾病治疗提供有效的科学依据。方法选取本院2009年10月～2012年12月诊治的视神经脊髓炎患者37例为对照组,同期诊治的多发性硬化患者51例为观察组,均行脑脊液、MRI检查,分析两组患者脑干受损后的临床表现。结果观察组眼球震颤发生率、复视发生率均高于对照组,差异无统计学意义（P〉0.05）。观察组脑脊液细胞数明显少于对照组,脑脊液蛋白质水平明显低于对照组,脑脊液寡克隆带、头颅MRI异常、多发病灶、腹外侧受累、桥脑受累发生率均明显高于对照组,顽固性呃逆、呕吐,延髓受累、线样延髓征、线样延髓脊髓征、脊髓异常、融合病灶、髓内灰质受累发生率均明显低于对照组,差异均有统计学意义（P〈0.05）。结论引起顽固性呃逆、呕吐的视神经脊髓炎不同于多发性硬化,MRI检查中多伴有线样延髓征或线样延髓脊髓征。

The features analysis of multiple sclerosis and optic neuromyelitis caused by the intractable hiccup and vomit

Objective To discuss the clinical features of optic neuromyelitis caused by the intractable hiccup and vomit and multiple sclerosis in order to provide effective scientific basis for disease treatment. Methods 37 cases with optic neuromyelitis treated in our hospital from October 2009 to December 2012 were selected as the control group, then 51 cases with multiple sclerosis were selected as the observation group treated in our hospital at the same time. All patients were given the cerebrospinal fluid and MRI examination,then the clinical symptoms of the two groups after brain stem damage were analyzed. Results The incidence of nystagmus and diplopia in the observation group were higher than those in the control group,the differences were not statistically significant （ P 0.05）.The cerebrospinal fluid cell count and protein level in the observation group were lower than those in the control group,then the incidence of oligoclonal band of cerebrospinal fluid,brain MRI abnormality,multiple lesions,ventrolateral involvement,bridge brain involvement in observation group were higher than those in the control group,the incidence of intractable hiccup and vomit,bulbus rhachidicus involvement,linear bulbus rhachidicus syndrome,linear bulbus rhachidicus and spinal cord syndrome,spinal cord abnormality,fusion lesions,intramedullary gray matter involvement in the observation group were lower than those in the control group,the differences were statistically significant （ P 0.05）. Conclusion Optic neuromyelitis caused by the intractable hiccup and vomit is different from multiple sclerosis,its MRI examination shows the linear bulbus rhachidicus syndrome or linear bulbus rhachidicus and spinal cord syndrome.