Chang K H, Lyu R K, Chen C M, Hsu W C, Wu Y R, Chen S T, Ro L S
Section of Neuromuscular Diseases, Department of Neurology, Chang Gung Memorial Hospital and University, Taipei, Taiwan 10591.
Mult Scler. 2006 Aug;12(4):501-6. doi: 10.1191/1352458506ms1297oa.
This study reviewed the clinical characteristics of multiple sclerosis (MS) in Taiwanese patients from 1993 to 2001. Of the 75 MS patients with a mean age of onset of 35.6 +/- 12.6 years, the female-to-male ratio was 4.4 (61/14). In 42 (56%) optico-spinal MS (OS-MS) patients, the age of onset (37.6 +/- 11.1 years) tended to be older than conventional MS (C-MS) patients (33.1 +/- 14.1 years, P = 0.08). In 60 cerebrospinal fluid (CSF) specimens, raised IgG index (>0.7) and oligoclonal bands were noted in 26 (43.3%) and two (3.3%) cases, respectively. The frequency of raised IgG index was lower in OS-MS (31.3%) than in C-MS (57.1%, P = 0.07). The CSF total protein concentrations were significantly higher in OS-MS (64.5 mg/dL) than in C-MS (46.6 mg/dL, P = 0.047). The mean annual relapse rate was 54.1%, and was significantly higher within the first year (59.7%, P < 0.001). The mean annual relapse rate in OS-MS (62.7%) was significantly higher than in C-MS (41.2%, P=0.01). The differences in the annual relapse rate and total protein concentration in CSF between OS-MS and C-MS suggest probably two distinct immunopathogenesis. The higher first year relapse rate of MS patients in Taiwan may address the importance of early intervention with immunomodulatory therapy.
本研究回顾了1993年至2001年台湾地区多发性硬化症（MS）患者的临床特征。75例MS患者的平均发病年龄为35.6±12.6岁，女性与男性的比例为4.4（61/14）。42例（56%）视神经脊髓型MS（OS-MS）患者的发病年龄（37.6±11.1岁）往往比传统型MS（C-MS）患者（33.1±14.1岁）大（P=0.08）。在60份脑脊液（CSF）标本中，分别有26例（43.3%）和2例（3.3%）检测到IgG指数升高（>0.7）和寡克隆带。OS-MS患者中IgG指数升高的频率（31.3%）低于C-MS患者（57.1%，P=0.07）。OS-MS患者脑脊液总蛋白浓度（64.5mg/dL）显著高于C-MS患者（46.6mg/dL，P=0.047）。年平均复发率为54.1%，第一年的复发率显著更高（59.7%，P<0.001）。OS-MS患者的年平均复发率（62.7%）显著高于C-MS患者（41.2%，P=0.01）。OS-MS和C-MS患者脑脊液年复发率和总蛋白浓度的差异可能提示两种不同的免疫发病机制。台湾地区MS患者第一年较高的复发率可能表明早期免疫调节治疗干预的重要性。
