Liu Yaou, Duan Yunyun, Yu Chunshui, Qin Wen, Chen Hai, Dong Huiqing, Ye Jing, Butzkueven Helmut, Li Kuncheng
Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, PR China.
Clin Neurol Neurosurg. 2011 Oct;113(8):658-60. doi: 10.1016/j.clineuro.2011.05.013. Epub 2011 Jun 16.
To summarize the characteristics of Chinese clinically isolated syndrome (CIS) patients and their 3-year follow-up results. Investigate the relationship between CIS features and clinical outcomes.
Forty-nine CIS patients were recruited and 42 of them were able to be followed up for a mean of 38 months (range 26-48 months). We recorded baseline features including patient demographics, site of CIS, presence or absence of cerebrospinal fluid (CSF) oligoclonal bands (OCB) and MRI lesions in brain and spinal cord. The incidence of conversion to clinically definite MS (CDMS) or neuromyelitis optica (NMO) after CIS was calculated, and the relationship between baseline features and CDMS was explored. All data were statistically processed with SPSS for Windows Version 11.5.
After a mean follow-up of 38 months, 10/42 patients had converted to CDMS (24%), and one patient had developed definite NMO. The other 31 patients remained in CIS status. A spinal cord syndrome was the initial CIS manifestation in 57% of patients. The conversion rates to MS were 22% (5/23) for patients presenting with a spinal cord syndrome and 27% (3/11) for multi-focal manifestations. The three-year CDMS conversion rates were 70% (7/10) for patients who fulfilled the MRI dissemination in space criteria (2005 revised McDonald) at onset of CIS, while only 9% (3/32) of patients who did not fulfill these criteria converted to CDMS. Females had significantly higher conversion rate than males.
A spinal cord syndrome was the most common initial presentation of our Chinese CIS group. After a mean follow-up of 38 months, the conversion rate to MS was approximately 25%. The 2005 revised McDonald MRI criteria for dissemination in space is a key prognostic factor for conversion to MS in CIS in Chinese patients.
总结中国临床孤立综合征（CIS）患者的特征及其3年随访结果。探讨CIS特征与临床结局之间的关系。
招募了49例CIS患者，其中42例能够进行平均38个月（范围26 - 48个月）的随访。我们记录了基线特征，包括患者人口统计学资料、CIS部位、脑脊液（CSF）寡克隆带（OCB）的有无以及脑和脊髓的MRI病变。计算CIS后转化为临床确诊多发性硬化（CDMS）或视神经脊髓炎（NMO）的发生率，并探讨基线特征与CDMS之间的关系。所有数据均使用SPSS for Windows 11.5版本进行统计处理。
平均随访38个月后，10/42例患者转化为CDMS（24%），1例患者发展为确诊的NMO。其他31例患者仍处于CIS状态。57%的患者最初的CIS表现为脊髓综合征。表现为脊髓综合征的患者转化为MS的发生率为22%（5/23），多灶性表现的患者为27%（3/11）。CIS发病时符合2005年修订的McDonald空间播散MRI标准的患者三年CDMS转化率为70%（7/10），而不符合这些标准的患者只有9%（3/32）转化为CDMS。女性的转化率显著高于男性。
脊髓综合征是我们中国CIS组最常见的初始表现。平均随访38个月后，转化为MS的发生率约为25%。2005年修订的McDonald空间播散MRI标准是中国CIS患者转化为MS的关键预后因素。
