Department of Neurology, University Hospital of Dijon, 3 rue du Faubourg Raines, 21000, Dijon, France.
J Neurol. 2013 Oct;260(10):2629-37. doi: 10.1007/s00415-013-7041-9. Epub 2013 Aug 2.
The nature and frequency of comorbidities upon notification of multiple sclerosis (MS) are not well known. In France, MS is one of the 30 long-term illnesses (affections de longue durée, ALD) for which 100 % of patients' health care costs are covered by the main French health insurance system. We conducted a study among 22,087 patients who had contracted MS before their 45th birthday and had obtained ALD status between 1995 and 2004. Comorbidities diagnosed at MS notification were described. The age at which MS was registered in patients with a previous comorbidity was compared with that in those patients with no previous comorbidities. Among the 22,087 patients, 21,119 (95 %) had ALD status for MS only, 653 (3 %) had a comorbidity status diagnosed at the same time as MS. Of these comorbidities, 86.8 % could be grouped into five main categories: psychiatric disease (40.2 %), autoimmune disease (24.5 %), cardiovascular disease (16.2 %), cancer (12.2 %), and metabolic disease (9.0 %). Psychiatric disorders and diabetes were more frequent in MS patients than in the general population of the same age. The mean age at request for ALD status for MS in patients with no comorbidity was 33.6 ± 7.2 years, whereas it was 36.9 ± 6.5 years in those with comorbidities. Comorbidities at MS notification are rare. Psychiatric disorders and diabetes were more frequent in MS patients than in the general population.
多发性硬化症(MS)确诊时伴发的合并症的性质和频率尚不清楚。在法国,MS 是 30 种长期疾病(ALD)之一,其全部医疗费用由主要的法国健康保险系统承担。我们对 22087 名在 45 岁生日之前确诊 MS 且在 1995 年至 2004 年间获得 ALD 身份的患者进行了一项研究。描述了 MS 确诊时诊断出的合并症。比较了患有先前合并症的患者与无先前合并症的患者的 MS 登记年龄。在 22087 名患者中,21119 名(95%)仅有 MS 的 ALD 身份,653 名(3%)同时被诊断出合并症。在这些合并症中,86.8%可以归入五个主要类别:精神疾病(40.2%)、自身免疫性疾病(24.5%)、心血管疾病(16.2%)、癌症(12.2%)和代谢性疾病(9.0%)。精神障碍和糖尿病在 MS 患者中的发生率高于同年龄的一般人群。无合并症的 MS 患者申请 ALD 身份的平均年龄为 33.6±7.2 岁,而有合并症的患者为 36.9±6.5 岁。MS 确诊时的合并症很少见。与一般人群相比,精神障碍和糖尿病在 MS 患者中更为常见。