63例视神经脊髓炎患者临床特点及尿酸水平分析

目的 分析63例视神经脊髓炎患者的临床特点并评价其血清尿酸水平.方法 分析患者首发症状、影像学表现,同时尿酶法检测血清尿酸水平,与66名健康对照比较.结果 初次发病平均年龄(39.43±14.76)岁,女性占93.7％；以视力损害首发36.5％,脊髓症状首发34.9％；影像学提示颈、胸髓受累分别为27.0％和44.4％,脑部病变占39.7％；病例组尿酸水平(224.73±66.07)μmol/L,对照组为(310.00±79.99)μmol/L,两组比较P＜0.05.结论 视神经脊髓炎患者首发症状无特异性,脑部损害并不罕见但无特异性,血清尿酸水平较正常对照为低,二者比较差异有统计学意义.

Analysis of clinical features and serum uric acid level in 63 patients with neuromyelitis optica

OBJECTIVE To investigate the clinical features of neuromyelitis optica and association between neuromyelitis optica and serum uric acid.METHODS 63 patients with definitive neuromyelitis optica were retrospectively analyzed,including clinical manifestation and neuroimage findings,then serum uric acid level among these individuals were compared with 66 gender-and age-matched healthy controls.RESULTS Mean age at onset of the patients was 39.43 ± 14.76 years,93.7% of the them were females;optic neuritis was the most common presentation at onset(36.5%),then followed by myelitis(34.9%);27% had cervical spinal cord lesion and 44.4% had thoracic spinal cord injury.MRI showed that 39.7% of the patients had intracranial focus.Serum uric acid level in patients with neuromyelitis optica was significantly lower than that of healthy controls(224.73 ± 66.07μmol/L vs 310.00 ± 79.99μmol/L,P﹤0.05).CONCLUSION Visual loss or myelitis is common initial manifestation of neuromyelitis optica,myelitis is typically associated with lesions extending over 3 vertebral segments.Brain MRI findings are not uncommon but generally nonspecific,the results also reveal a decreased serum uric acid level of neuromyelitis optica patients,it indicates that replacement therapy with serum acid or its precursors may be beneficial to the patients with neuromyelitis optica.