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山东大学学报 (医学版) ›› 2023, Vol. 61 ›› Issue (5): 37-43.doi: 10.6040/j.issn.1671-7554.0.2022.0986

• 临床医学 • 上一篇    

47例单个脊髓炎性脱髓鞘病灶转化的影响因素

李晴1,张安娜2,杜艳圣3,刁久洲3,崔若瑾3,付鹏蕊3,岳欣毅3,周庆博3   

  1. 1.山东大学第二医院全科医学科, 山东 济南 250033;2.山东大学第二医院南部院区老年病医学科, 山东 济南 250013;3.山东大学第二医院神经内科, 山东 济南 250033
  • 发布日期:2023-05-15
  • 通讯作者: 周庆博. E-mail:lianxiang1210@163.com

Influencing factors of the transformation of single demyelinating lesion of spinal cord in 47 cases

LI Qing1, ZHANG Anna2, DU Yansheng3, DIAO Jiuzhou3, CUI Ruojin3, FU Pengrui3, YUE Xinyi3, ZHOU Qingbo3   

  1. 1. Department of General Practice, The Second Hospital of Shandong University, Jinan 250033, Shandong, China;
    2. Department of Geriatrics, South Branch of the Second Hospital, Shandong University, Jinan 250013, Shandong, China;
    3. Department of Neurology, The Second Hospital of Shandong University, Jinan 250033, Shandong, China
  • Published:2023-05-15

摘要: 目的 分析47例单个脊髓炎性脱髓鞘病灶患者疾病转化的影响因素。 方法 采用回顾性研究方法,搜集92例首发影像表现为单个脊髓炎性脱髓鞘病灶的患者,根据随访是否出现向视神经脊髓炎谱系疾病(NMOSD)、多发性硬化(MS)或抗髓鞘少突胶质细胞糖蛋白免疫球蛋白G抗体相关疾病(MOG-AD)转化分为转化组(n=47)与非转化组(n=45):采用独立样本t检验、χ2检验、Fisher确切概率法或Mann-Whitney U检验比较两组临床资料,二分类Logistic回归分析疾病转化的独立危险因素。 结果 在47例转化组和45例非转化组中,疾病转化与年龄、随访过程中出现视力障碍、脊髓MRI累及节段≥3个、风湿系列异常、中枢神经系统(CNS)脱髓鞘抗体阳性及复发存在统计学意义(P<0.05)。二分类Logistic回归分析显示复发(OR=6.850,95%CI:2.206~21.270,P=0.001)、MRI累及节段≥3个(OR=3.968,95%CI:1.230~12.805,P=0.021)、CNS脱髓鞘抗体阳性(OR=19.983,95%CI:2.258~176.816,P=0.007)是转化的独立危险因素。 结论 单个脊髓炎性脱髓鞘病灶的转化与年龄、随访过程中出现视力障碍、MRI长度、CNS脱髓鞘抗体、风湿系列抗体、复发多种因素相关。

关键词: 脱髓鞘, 脊髓炎, 复发, 转化, 磁共振, 水通道蛋白4

Abstract: Objective To analyze the influencing factors of disease transformation in 47 patients with single demyelinating lesion of spinal cord. Methods The clinical data of 92 patients with single demyelinating lesion of spinal cord were retrospectively analyzed. According to the presence of neuromyelitis optica spectrum disorders(NMOSD), multiple sclerosis(MS), and myelin oligodendrocytes glycoprotein associated disorders(MOG-AD)during the follow-up, the patients were divided into transformed group(n=47)and non-transformed group(n=45). Independent-samples t test, χ2 test, Fishers exact test or Mann-Whitney U test were used to compare the clinical data of the two groups. The independent risk factors of disease transformation were analyzed with binary Logistic regression. Results There were significant association between disease transformation and patients age, visual impairment during follow-up, segments of spinal cord ≥3, abnormality of rheumatic series, positive central nervous system demyelinating antibody and recurrence(P<0.05). Binary Logistic regression analysis showed that recurrence(OR=6.850, 95%CI: 2.206-21.270, P=0.001), segments of spinal cord ≥3(OR=3.968, 95%CI: 1.230-12.805, P=0.021), and positive central nervous system demyelinating antibody(OR=19.983, 95%CI: 2.258-176.816, P=0.007)were independent risk factors of disease transformation. Conclusion The transformation of a single demyelinating lesion of spinal cord is associated with age, visual impairment during follow-up, segments of spinal cord ≥3, positive central nervous system demyelinating antibody, abnormality of rheumatism series and recurrence.

Key words: Demyelination, Myelitis, Recurrence, Transformation, Magnetic resonance imaging, Aquaporin-4

中图分类号: 

  • R741
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