摘要
目的 总结国人多发性硬化 ( MS)的临床、影像及病理学特点。方法 从临床、影像学及组织病理学等多方面对 MS病例进行回顾性分析。结果 2 2 6例 MS病例中 ,临床确诊 1 96例 ,实验室支持确诊 1 6例 ,临床或实验室可能 1 4例 ;男性 85例 ,女性 1 41例 ;发病年龄 4岁至 67岁 ,平均 3 2 .46岁 ,<1 5岁的早发型病例占 9.3 % ;3 0 .1 %病例病前有诱发因素 ,其中 77.9%与感染有关 ;首发症状以感觉异常、肢体无力及视力减退最为多见 ;88.1 %病例呈急性或亚急性起病 ,复发 -缓解型占 49.1 % ;病变部位中脊髓 1 5 1例 ,脑干 74例 ,小脑 2 4例 ,大脑半球 95例 ,视神经 98例 ;66.8%病例出现脊髓受累 ,5 0 .4%病例曾出现过尿便障碍 ,其中视神经脊髓炎占2 9.2 %。结论 国内 MS的发病年龄较西方国家早 ,起病急 ,病程短 ,视神经及脊髓易受侵犯 ,小脑、脑干较少受累 ,临床表现中以视神经受损及尿便障碍较为突出 ,致残率较高。诱发电位及 MRI检查有助于发现亚临床病变。急性、亚急性期应用激素疗效显著。
Objective To summarize the clinical, imaging and pathological characteristics of MS. Methods We have retrospectively studied the characteristics of 226 MS cases on clinic,imaging and histopathology. Results Among 226 MS cases, there are 196 clinically confirmed MS, 16 laboratory supported definite MS and 14 clinically or laboratory findings favouring MS. All together there are 85 in male and 141 in female. The first onset age are from 4 to 67 years old. The children type (<15 years old) of MS holds 9.3%. Before illness, 30.1% cases have evoking factors in which 77.9% are relevant to infections. Paresthesia, weakness and visual deterioration are the most common initial symptoms. 88.1% have acute and subacute courses and 49.1% have relapses. The location of the lesions have 151 cases in spinal cord, 74 cases in brain stem, 24 cases in cerebellum, 95 cases in cerebral hemisphere and 98 cases in optic nerve. 66.8% have spinal cord symptom, 50.4% have urinary or bowel dysfunction. 29.2% were diagnosed Devic disease. Conclusions The onset age of MS in China is younger than western country and the episode is more urgent, the course is shorter. Optic nerve and spinal cord are easy to be invasived. Cerebellum and brain stem are seldom involved. In the clinical situation, optic nerve damage and urinary or bowel dysfunction are prominent which cause the high mutilation rate. Evoked potentialsmayfindtheparaclinicalorsilentlesions.TreatmentoftheacuteorsubacuteMSwith corticosteroids is effective.
出处
《中国神经免疫学和神经病学杂志》
CAS
2003年第3期152-155,共4页
Chinese Journal of Neuroimmunology and Neurology
基金
全军"十五"重点课题资金资助项目 ( 0 1Z0 41)
关键词
炎性脱髓鞘病
多发性硬化
磁共振成像
病理学
demyelinating disease
multiple sclerosis
magnetic resonance imaging
pathology
