Debouverie M, Lebrun C, Jeannin S, Pittion-Vouyovitch S, Roederer T, Vespignani H
Department of Neurology, Central Hospital, Nancy, France.
Neurology. 2007 Jan 2;68(1):29-32. doi: 10.1212/01.wnl.0000250347.51674.d7.
To compare the clinical disease progression in European (E) and North African (NA) patients with multiple sclerosis (MS) patients in France.
We compared the clinical features of MS in 211 NA patients and 2,945 E patients in a French population-based cohort with definite MS according to McDonald's criteria.
Among the NA patients with MS, 66.4% were women vs 72.9% of the E patients (p = 0.04), 15.6% had a primary progressive form of MS vs 11.7% of the E patients (p = 0.08), and the mean age at onset was 29.9 +/- 9.8 years in the NA patients vs 32.9 +/- 10.6 years in the E patients (p < 0.0001). In the NA patients, there was a higher proportion of patients with incomplete recovery from the first relapse (p < 0.0001), a shorter time between the first two relapses (p = 0.02), a higher number of relapses in the first 5 years (p = 0.03), and a shorter time to reach an Expanded Disability Status Scale score of 4.0 (p = 0.001) or 6.0 (p < 0.0001). The only statistical difference in these factors between NA patients born in France and those born in North Africa was the mean age at onset of symptoms: it was earlier in NA patients born in France (p < 0.0001).
The course of multiple sclerosis is more aggressive in North African than in European patients.
比较法国欧洲裔（E）和北非裔（NA）多发性硬化（MS）患者的临床疾病进展情况。
我们在一个基于法国人群的队列中，根据麦克唐纳标准对211例NA患者和2945例E患者的MS临床特征进行了比较。
在患有MS的NA患者中，66.4%为女性，而E患者中这一比例为72.9%（p = 0.04）；15.6%患有原发性进行性MS，而E患者中这一比例为11.7%（p = 0.08）；NA患者的平均发病年龄为29.9±9.8岁，E患者为32.9±10.6岁（p < 0.0001）。在NA患者中，首次复发后未完全恢复的患者比例更高（p < 0.0001），前两次复发之间的时间更短（p = 0.02），前5年的复发次数更多（p = 0.03），达到扩展残疾状态量表评分4.0（p = 0.001）或6.0（p < 0.0001）的时间更短。在法国出生的NA患者和在北非出生的NA患者之间，这些因素的唯一统计学差异是症状的平均发病年龄：在法国出生的NA患者中发病年龄更早（p < 0.0001）。
多发性硬化的病程在北非患者中比在欧洲患者中更具侵袭性。
