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Neurology. 2011 Sep 20;77(12):1143-8. doi: 10.1212/WNL.0b013e31822facdd. Epub 2011 Aug 24.
To determine whether the incidence and clinical features of pediatric multiple sclerosis (MS) and other forms of pediatric acquired demyelinating syndromes (ADS) vary by race/ethnicity in a population-based cohort.
We used a combination of electronic database searches followed by complete medical records review to identify all children diagnosed with MS and ADS in the multiethnic membership of Kaiser Permanente Southern California from January 1, 2004, to December 31, 2009. Incidence rates were standardized to the US census by age and gender.
We identified 81 incident cases of ADS from 4.87 million person-years of observation in children 0-18 years of age. The incidence rate of pediatric MS was 0.51 per 100,000 person-years (95% confidence interval [CI] 0.33-0.75) and incidence of other forms of ADS including optic neuritis, transverse myelitis, other forms of clinically isolated syndrome (CIS), and acute disseminated encephalomyelitis (ADEM) was 1.56 (95% CI 1.23-1.95) for an overall incidence of ADS of 1.66 per 100,000 person-years (95% CI 1.32-2.06). Incidence of ADS was higher in black (4.4 per 100,000 person-years, 95% CI 2.5-7.2, p < 0.001) and Asian/Pacific Islander (2.8, 95% CI 1.2-5.2, p = 0.02) than white (1.03, 95% CI 0.6-1.7) and Hispanic (1.5, 95% CI 1.1-2.1, per 100,000 person-years) children. Black children were also significantly more likely to have MS than white children (p = 0.001). Children who presented with ADEM were significantly younger than children with other types of ADS clinical presentations (mean age 5.6, range 0.7-17.6 years vs 14.6, range 2.7-18.5, respectively).
The incidence of pediatric acquired demyelinating syndromes is 1.66 per 100,000 person-years in a population-based cohort of Southern Californian children. The incidence of ADS and MS is higher in black children compared with white and Hispanic children.
在一个基于人群的队列中，确定儿科多发性硬化症（MS）和其他形式的儿科获得性脱髓鞘综合征（ADS）的发病率和临床特征是否因种族/民族而异。
我们使用电子数据库搜索结合完整的病历回顾，以确定 2004 年 1 月 1 日至 2009 年 12 月 31 日期间在凯撒永久南加州的多种族成员中诊断为 MS 和 ADS 的所有儿童。发病率按年龄和性别标准化为美国人口普查。
我们在 0-18 岁儿童的 487 万人年观察中发现了 81 例 ADS 新发病例。儿科 MS 的发病率为 0.51/10 万人年（95%置信区间 [CI] 0.33-0.75），视神经炎、横贯性脊髓炎、其他形式的临床孤立综合征（CIS）和急性播散性脑脊髓炎（ADEM）等其他形式的 ADS 的发病率为 1.56/10 万人年（95%CI 1.23-1.95），ADS 的总发病率为 1.66/10 万人年（95%CI 1.32-2.06）。黑人（4.4/10 万人年，95%CI 2.5-7.2，p<0.001）和亚裔/太平洋岛民（2.8，95%CI 1.2-5.2，p=0.02）儿童的 ADS 发病率高于白人（1.03，95%CI 0.6-1.7）和西班牙裔（1.5，95%CI 1.1-2.1，每 10 万人年）。黑人儿童患 MS 的可能性也明显高于白人儿童（p=0.001）。患有 ADEM 的儿童明显比患有其他类型 ADS 临床表现的儿童年轻（平均年龄 5.6 岁，范围 0.7-17.6 岁 vs 14.6 岁，范围 2.7-18.5 岁）。
在南加州儿童的基于人群的队列中，儿科获得性脱髓鞘综合征的发病率为每 10 万人年 1.66 例。黑人儿童的 ADS 和 MS 发病率高于白人儿童和西班牙裔儿童。
