Cheng X-J, Cheng Q, Xu L-Z, Zhao H-Q, Zhao Z, Wang W, Jiang G-X, Fredrikson S
Department of Neurology, Ruijin Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China.
Acta Neurol Scand. 2010 Jan;121(1):24-9. doi: 10.1111/j.1600-0404.2009.01276.x. Epub 2009 Oct 5.
To evaluate the discharge diagnosis of demyelinating diseases in the central nervous system (CNS) and analyze the predictive value of the new diagnostic criteria in Suzhou, China.
We collected clinical information and data of laboratory examinations for all cases with a diagnosis of various demyelinating diseases in the CNS. All data were reviewed individually by four senior neurologists, and a diagnosis was finally given to each patient according to the McDonald criteria and the Poser criteria for multiple sclerosis (MS).
In the analysis, 176 patients with a diagnosis of demyelinating diseases in the CNS at discharge were included. In 82 patients with a diagnosis of MS at discharge, the MS diagnosis was confirmed for 74 patients according to the McDonald criteria for MS, and the positive predictive value for the discharge diagnosis of MS was 90.2% (74/82). According to the Poser criteria, 61 patients were diagnosed as MS. The consistency of the two diagnostic criteria for MS was 78.4%, based on the results of the evaluation.
Under-diagnosis of MS could be one of the explanations for the low prevalence of MS in China. Compared to the Poser criteria, the McDonald criteria had a higher sensitivity for the diagnosis of MS.
评估中枢神经系统（CNS）脱髓鞘疾病的出院诊断情况，并分析新诊断标准在中国苏州的预测价值。
我们收集了所有诊断为中枢神经系统各种脱髓鞘疾病病例的临床信息和实验室检查数据。所有数据由四位资深神经科医生分别进行审查，最终根据麦克唐纳标准和多发性硬化症（MS）的波泽标准对每位患者做出诊断。
分析纳入了176例出院时诊断为中枢神经系统脱髓鞘疾病的患者。在82例出院时诊断为MS的患者中，根据MS的麦克唐纳标准，74例患者的MS诊断得到确认，MS出院诊断的阳性预测值为90.2%（74/82）。根据波泽标准，61例患者被诊断为MS。基于评估结果，两种MS诊断标准的一致性为78.4%。
MS诊断不足可能是中国MS患病率较低的原因之一。与波泽标准相比，麦克唐纳标准对MS诊断的敏感性更高。
