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波兰多发性硬化症的流行病学研究:一项多中心的初步研究。

Selected aspects of the epidemiology of multiple sclerosis in Poland - a multicentre pilot study.

机构信息

Klinika Neurologii Uniwersytetu Medycznego w Białymstoku, ul. Skłodowskiej-Curie 24A, 15-276 Białystok.

出版信息

Neurol Neurochir Pol. 2010 Sep-Oct;44(5):443-52. doi: 10.1016/s0028-3843(14)60134-1.

Abstract

BACKGROUND AND PURPOSE

The aim was to conduct a pilot study of selected epidemiological aspects of multiple sclerosis (MS) in Poland.

MATERIAL AND METHODS

Cross-sectional data were collected in 21 centres providing MS treatment. The demographic profile of the patients, medical history of MS, disability status, comorbidity, and diagnostic and treatment modalities were analysed.

RESULTS

Data on 3581 patients were obtained, including 2494 women (69.6%) and 1030 men (28.8%) - sex ratio 2.4 : 1. The mean age was 40.7 ± 11.9 years. Monofocal onset was reported in 80.8% of cases - the most frequently reported location of lesions was supratentorial (36.1%), followed by optic nerves (26.5%) and spinal cord (20.1%). The mean disease duration was 10.2 ± 8.8 years (range 0.04-53 years), and the mean time from the first symptoms to MS diagnosis was 2.6 years. Relapsing-remitting MS was reported in 70.5% of patients, secondary progressive in 16.8%, primary progressive in 8.4%, and 'benign MS' in 2.5%. The mean EDSS score was 3.3 ± 2.2 (range 0-9.5). The family history of MS was positive in 6.4% of cases. Comorbidity mainly applied to the musculoskeletal system (6.5%), the urinary system (5.8%) and psychiatric disturbances (5.5%). Brain magnetic resonance studies were available in 96.3% of the patients, evoked potentials in 54%, and cerebrospinal fluid testing in 63.1% - of whom only 41.2% were tested for oligoclonal bands, with 84% of samples being positive. Immunomodulatory drugs were used in 842 patients (24%), predominantly interferon beta (81%) and glatiramer (13%). Mitoxantrone was the most commonly used immunosuppressant.

CONCLUSIONS

This project is the first countrywide large-scale MS survey, covering approximately 18% of patients, according to our estimates. The results identify the clinical condition of the patients, as well as diagnostic and treatment modalities.

摘要

背景与目的

本研究旨在对波兰多发性硬化症(MS)的部分流行病学特征进行初步研究。

材料与方法

在 21 个提供 MS 治疗的中心收集横断面数据。分析患者的人口统计学特征、MS 病史、残疾状况、合并症、诊断和治疗方式。

结果

共获得 3581 例患者的数据,其中女性 2494 例(69.6%),男性 1030 例(28.8%),男女比例为 2.4:1。平均年龄为 40.7±11.9 岁。80.8%的患者为单灶起病,最常报道的病变部位是幕上(36.1%),其次是视神经(26.5%)和脊髓(20.1%)。平均病程为 10.2±8.8 年(范围 0.04-53 年),从首发症状到 MS 诊断的平均时间为 2.6 年。70.5%的患者为复发缓解型 MS,16.8%为继发进展型,8.4%为原发进展型,2.5%为“良性 MS”。平均 EDSS 评分为 3.3±2.2(范围 0-9.5)。MS 家族史阳性率为 6.4%。合并症主要涉及肌肉骨骼系统(6.5%)、泌尿系统(5.8%)和精神障碍(5.5%)。96.3%的患者行脑部磁共振检查,54%行诱发电位检查,63.1%行脑脊液检查,但仅 41.2%检测寡克隆带,阳性率为 84%。1824 例(51%)患者使用免疫调节剂,主要为干扰素β(81%)和那他珠单抗(13%)。米托蒽醌是最常用的免疫抑制剂。

结论

本研究是波兰首次全国范围内的 MS 大规模调查,据我们估计,覆盖了约 18%的患者。研究结果明确了患者的临床状况以及诊断和治疗方式。

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