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在台湾的视神经脊髓炎患者中长脊髓病变和抗水通道蛋白 4 抗体的流行情况。

The prevalence of long spinal cord lesions and anti-aquaporin 4 antibodies in neuromyelitis optica patients in Taiwan.

机构信息

Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC.

出版信息

Eur Neurol. 2011;65(2):99-104. doi: 10.1159/000322740. Epub 2011 Jan 27.

Abstract

BACKGROUND AND OBJECTIVE

It was the aim of this study to determine the prevalence of anti-aquaporin 4 antibody (anti-AQP4 Ab) and long spinal cord lesions in neuromyelitis optica (NMO) and multiple sclerosis (MS) patients in Taiwan. Asia has a relatively high rate of NMO compared with MS patients. Anti-AQP4 Ab is an important marker for NMO worldwide, but serological data and clinical profiles of NMO patients in Taiwan have not been reported.

METHODS

This retrospective study compared the clinical symptoms, demographics, spinal cord lesion length and AQP4 Ab status of 34 patients with NMO with 34 patients diagnosed with conventional MS.

RESULTS

Our NMO patients were predominantly middle-aged women (median age 45 years), exhibited many relapses (1.0/year) and displayed a higher Expanded Disability Status Scale score (4.75) than conventional MS patients. NMO patients exhibited long spinal cord lesions as detected by MRI. Forty-one percent of the NMO patients had detectable anti-AQP4 Ab. The Expanded Disability Status Scale score was significantly higher in AQP4 Ab- NMO patients.

CONCLUSION

The prevalence of AQP4 Ab in a Taiwanese NMO group was 41%. Long spinal cord lesions and detection of AQP4 Ab helped to differentiate NMO patients from MS patients. Long spinal cord lesions with the anti-AQP4 Ab test may allow for an earlier diagnosis of NMO and improve therapeutic decisions.

摘要

背景与目的

本研究旨在确定抗水通道蛋白 4 抗体(抗 AQP4Ab)在台湾的视神经脊髓炎(NMO)和多发性硬化(MS)患者中的流行率。亚洲的 NMO 发病率相对较高,而 MS 发病率则相对较低。抗 AQP4Ab 是全球 NMO 的重要标志物,但台湾 NMO 患者的血清学数据和临床特征尚未有报道。

方法

本回顾性研究比较了 34 例 NMO 患者和 34 例确诊为常规 MS 患者的临床症状、人口统计学资料、脊髓病变长度和 AQP4Ab 状态。

结果

我们的 NMO 患者主要为中年女性(中位年龄 45 岁),发作频繁(每年 1.0 次),扩展残疾状况量表评分(EDSS)较高(4.75)。NMO 患者的 MRI 显示长脊髓病变。41%的 NMO 患者可检测到抗 AQP4Ab。抗 AQP4Ab 阴性的 NMO 患者的 EDSS 评分明显更高。

结论

在台湾的 NMO 患者中,抗 AQP4Ab 的流行率为 41%。长脊髓病变和抗 AQP4Ab 的检测有助于将 NMO 患者与 MS 患者区分开来。长脊髓病变伴抗 AQP4Ab 检测可能有助于更早诊断 NMO,并改善治疗决策。

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