Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon.
Int J Neurosci. 2010 Mar;120(3):206-10. doi: 10.3109/00207450903464587.
Multiple sclerosis (MS) has a variable disease course. Identifying early predictive prognostic factors is of paramount importance. Most of the data on these factors however comes from studies performed in western countries. Such data is lacking in the Arab World. The objective of this study is to identify early predictors of disability among MS patients in Lebanon.
75 relapsing-remitting MS patients with 5 year follow-up from disease onset were selected from Project MS Lebanon database. The following parameters were studied as potential causes of early disability as defined by an EDSS > or = 3, after five years from disease onset: age at onset of MS, gender, interval between first and second attack, residual deficit after first attack, initial symptoms, treatment for at least 1 year in the first 5 years, and the number of relapses in the first 2 and 5 years.
Patients with incomplete recovery from the first relapse were 11.66 times more likely to have a higher EDSS after 5 years (CI = 2.02-67.31, p = .001). Furthermore, the number of relapses during the first 5 years was also an independent predictor of EDSS > or = 3 at 5 years (p = .024). Other factors were not shown to predict a worse outcome.
Overall, early predictors of disability in MS among the Lebanese population were not very different from similar predictors in western countries.
多发性硬化症(MS)的病程多变。识别早期预测预后的因素至关重要。然而,这些因素的数据大多来自西方国家的研究。阿拉伯世界缺乏此类数据。本研究的目的是确定黎巴嫩 MS 患者发生残疾的早期预测因素。
从黎巴嫩多发性硬化症项目数据库中选择了 75 例发病后 5 年随访的复发缓解型 MS 患者。研究了以下参数,作为发病后 5 年内 EDSS ≥ 3 定义的早期残疾的潜在原因:MS 发病年龄、性别、首次和第二次发作之间的间隔、首次发作后的残留缺陷、初始症状、至少在头 5 年中进行了 1 年的治疗以及头 2 年和 5 年内的复发次数。
首次复发未完全恢复的患者在 5 年后发生更高 EDSS 的可能性高 11.66 倍(CI = 2.02-67.31,p =.001)。此外,头 5 年内的复发次数也是 EDSS ≥ 3 的独立预测因素(p =.024)。其他因素并未显示出预测不良结局的能力。
总体而言,黎巴嫩人群中 MS 残疾的早期预测因素与西方国家的类似预测因素并没有太大区别。