Sobue I, Aoki K, Ohtani M
Jpn J Med Sci Biol. 1975;28 Suppl:203-17.
The following points have become clear on prognosis of SMON through the analysis of 981 cases collected. 1) The prognosis of the old whose ages were 60 year old or over is not favorable, when compared with that of the young. However, there is no prognostic difference between male and female. 2) The cummulative death rate of SMON which was calculated by the life table method is approx twice as much as the generally expected value. 3) Approximately 80% of the patients showed some sort of improvement 7 to 12 months after the onset of the disease. The rate for 13 months or over if nearly the same. 4) The abdominal symptoms found at the time of the onset of the disease decreased markedly in the course of the disease. 5) Among neurological symptoms, the prognosis of motor disorders is more favorable. The complete recovery of sensory disturbances was extremely rare, but approx 60% showed more or less favorable in the course of the illness. Approximately 40% of the cases with visual disturbances completely recovered or showed favorable improvement, whereas 9% of them became worse. As for the prognosis of visual impairment, it is more serious than other symptoms. 6) The patients who had been administered clioquinol over long period displayed a higher rate of severe or moderate motor, sensory and visual disturbances, compared with the group with short-term administration of clioquinol. The death rate was also higher in the former group. 7) The rate of relapse as a whole was 16.7% and 68% of them was seen within 18 months after the onset. There is no difference in relapse according to sex. There was seen a high rate of relapse in the group of longterm administration of clioquinol. 8) A 10.5% of total cases were either unable to walk or in need of assistance in walking, whereas the rate of patients who cannot get dressed or who cannot defecate unassisted was lower. 9) Approximately 65% returned to the job in 12 months or more after the onset. The employment rate was not different according to sex, whereas it was lower along with the age advances. 10) Approximately 20% were not received medical treatment. The rate of non-treated patients is higher in the younger patients. The rate of hospitalized patients was higher in the older patients.
通过对收集的981例患者的分析,关于亚急性脊髓视神经病(SMON)的预后已明确以下几点:1)60岁及以上的老年患者预后不如年轻患者。然而,男性和女性之间在预后方面没有差异。2)用寿命表法计算的SMON累积死亡率约为一般预期值的两倍。3)约80%的患者在发病7至12个月后有某种程度的改善。13个月及以上的改善率几乎相同。4)发病时出现的腹部症状在病程中明显减轻。5)在神经症状中,运动障碍的预后较好。感觉障碍完全恢复极为罕见,但约60%在病程中或多或少有所改善。约40%的视力障碍患者完全恢复或有良好改善,而其中9%的患者病情恶化。至于视力损害的预后,比其他症状更严重。6)长期服用氯碘羟喹的患者与短期服用氯碘羟喹的组相比,出现严重或中度运动、感觉和视力障碍的比例更高。前一组的死亡率也更高。7)总体复发率为16.7%,其中68%在发病后18个月内出现。复发率在性别上没有差异。长期服用氯碘羟喹的组复发率较高。8)10.5%的患者完全不能行走或需要辅助行走,而不能自行穿衣或不能自行排便的患者比例较低。9)约65%的患者在发病12个月或更长时间后重返工作岗位。就业率在性别上没有差异,但随着年龄增长而降低。10)约20%的患者未接受治疗。年轻患者中未接受治疗的比例较高。老年患者中住院患者的比例较高。