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目的:探讨视神经脊髓炎(neuromyelitis optica,NMO)与多发性硬化(multiple sclerosis,MS)的关系。方法:对 NMO 与 MS 的临床及病理进行比较分析。结果:NMO 可于幼年发病,症状和体征限于视神经和/或脊髓,亦可反复多次发病,病程较长;NMO 与 MS 患者脑脊液(CSF)寡克隆区带(OB)阳性率吻合为33%;电生理检查对发现临床及亚临床损害提供简捷易行的方法;在 NMO 中MRI 异常率为68%,在 MS 的异常率为64.52%。NMO 病理可见视神经和脊髓的萎缩、视神经元消失,脊髓可见脱髓鞘斑,大脑半球、脑干和小脑不受累,免疫组化可见 MS 和 NMO 患者新鲜病灶中有较多 T 淋巴细胞浸润,陈旧病灶内较少,IgG、IgA、IgM 及 C_3补体多见于巨噬细胞、星形细胞、浆细胞内。结论:NMO 与 MS 病变性质相同,支持 NMO 是 MS 的一个亚型。
Objective: To investigate the relationship between neuromyelitis optica (NMO) and multiple sclerosis (MS). Methods: The clinical and pathological changes of NMO and MS were compared. Results: The onset of NMO in juvenile rats was limited to the optic nerve and / or spinal cord. The onset of NMO was longer and longer. The positive rate of NMO in cerebrospinal fluid (CSF) oligodendroglia was 33% ; Electrophysiological examination for the discovery of clinical and subclinical damage provides a simple and easy method; NMO MRI abnormalities was 68%, the abnormal rate of 64.52% in MS. NMO pathological changes showed optic nerve and spinal cord atrophy, disappearance of optic neurons, demyelination of the spinal cord can be seen, the cerebral hemisphere, brainstem and cerebellum are not affected, immunohistochemistry showed MS and NMO patients with fresh lesions have more T lymphocyte infiltration, Fewer lesions, IgG, IgA, IgM and C_3 complement more common in macrophages, astrocytes, plasma cells. CONCLUSIONS: The NMO and MS lesions are of the same nature and support NMO as a subtype of MS.