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目的分析视神经脊髓炎(NMO)的临床特征。方法回顾性分析63例临床诊断为NMO患者的临床资料。结果男性8例,女性55例,平均发病年龄38.5岁,以急性或亚急性起病为主。所有患者均有同时或先后发生的视神经与脊髓的损害,脊髓损害主要表现为播散性或上升性脊髓炎。脊髓MRI检查显示病灶位于颈段26例(41.3%)、胸段19例(30.2%)、颈胸段12例(19.0%)、腰段3例(4.76%),病变节段均大于或等于3个椎体节段。视觉诱发电位有助于发现早期视神经损害。NMO患者脑脊液改变无特异性。预后差,复发率、致残率高,EDSS评分24例(38.1%)≥5分。结论 NMO女性多见,以视神经受累和长节段脊髓炎为主要表现,脑部症状少见。NMO复发率高,预后较差。
Objective To analyze the clinical features of optic neuromyelitis (NMO). Methods Retrospective analysis of 63 cases of clinically diagnosed patients with NMO clinical data. Results There were 8 males and 55 females, with an average age of 38.5 years old, with the majority of acute or subacute onset. All patients had simultaneous or sequential optic nerve and spinal cord injury, spinal cord injury mainly as disseminated or ascending myelitis. Spinal cord MRI showed that the lesions were located in the cervical segment in 26 cases (41.3%), thoracic segment in 19 cases (30.2%), cervical and thoracic segment in 12 cases (19.0%), lumbar segment in 3 cases (4.76%), lesion segments were greater than or equal to 3 vertebral segments. Visual evoked potentials help to detect early optic nerve damage. NMO patients with cerebrospinal fluid changes without specificity. Poor prognosis, recurrence rate, high morbidity, EDSS score 24 cases (38.1%) ≥ 5 points. Conclusion NMO women more common to optic nerve involvement and long section of myelitis as the main performance, rare brain symptoms. NMO recurrence rate is high, the prognosis is poor.