Children's Hospital Aschaffenburg, Aschaffenburg, Germany.
Centre for Health Informatics, Institute of Population Health, University of Manchester, Manchester, United Kingdom.
Ann Neurol. 2015 Jun;77(6):1076-82. doi: 10.1002/ana.24409. Epub 2015 May 11.
We retrospectively evaluated predictors of conversion to multiple sclerosis (MS) in 357 children with isolated optic neuritis (ON) as a first demyelinating event who had a median follow-up of 4.0 years. Multiple Cox proportional-hazards regressions revealed abnormal cranial magnet resonance imaging (cMRI; hazard ratio [HR] = 5.94, 95% confidence interval [CI] = 3.39-10.39, p < 0.001), presence of cerebrospinal fluid immunoglobulin G oligoclonal bands (OCB; HR = 3.69, 95% CI = 2.32-5.86, p < 0.001), and age (HR = 1.08 per year of age, 95% CI = 1.02-1.13, p = 0.003) as independent predictors of conversion, whereas sex and laterality (unilateral vs bilateral) had no influence. Combined cMRI and OCB positivity indicated a 26.84-fold higher HR for developing MS compared to double negativity (95% CI = 12.26-58.74, p < 0.001). Accordingly, cerebrospinal fluid analysis may supplement cMRI to determine the risk of MS in children with isolated ON.
我们回顾性评估了 357 例以孤立性视神经炎（ON）为首发脱髓鞘事件的儿童（中位随访时间为 4.0 年）向多发性硬化（MS）转化的预测因素。多 Cox 比例风险回归显示异常头颅磁共振成像（cMRI；风险比[HR] = 5.94，95%置信区间[CI] = 3.39-10.39，p < 0.001）、脑脊液免疫球蛋白 G 寡克隆带（OCB；HR = 3.69，95% CI = 2.32-5.86，p < 0.001）和年龄（HR = 每年 1.08 岁，95% CI = 1.02-1.13，p = 0.003）是转化的独立预测因素，而性别和偏侧性（单侧与双侧）无影响。cMRI 和 OCB 联合阳性提示发生 MS 的 HR 比双阴性高 26.84 倍（95% CI = 12.26-58.74，p < 0.001）。因此，脑脊液分析可能补充 cMRI 以确定孤立性 ON 儿童发生 MS 的风险。
