Cai Wei, Tan Sha, Zhang Lei, Shan Yilong, Wang Yanqiang, Lin Yinyao, Zhou Fangjing, Zhang Bingjun, Chen Xiaoyu, Zhou Li, Wang Yuge, Huang Xuehong, Men Xuejiao, Li Haiyan, Qiu Wei, Hu Xueqiang, Lu Zhengqi
Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, People's Republic of China.
Department of Neurology, The Fifth Affiliated Hospital of Sun Yat-sen University, People's Republic of China.
J Neurol Sci. 2016 Jan 15;360:88-93. doi: 10.1016/j.jns.2015.11.040. Epub 2015 Nov 25.
To investigate the relationship between linear lesions (LL) and the development of longitudinally extensive spinal cord lesions (LESCL) in Chinese patients with neuromyelitis optica or longitudinally extensive transverse myelitis.
The clinical records of 143 patients with these conditions were reviewed. Forty-one patients with LL were divided into three groups according to the order of appearance of LL and LESCL (simultaneously [n=10], LL first [n=26], or LESCL first [n=5]). The remaining 102 patients without LL were used as a control group.
Patients who developed LL first demonstrated a lower annualized relapse rate than those in the simultaneous group (1.00 [0.23-10.00] vs. 4.38 [0.60-6.67], p=0.017) and the control group (1.00 [0.23-10.00] vs. 2.00 [0.24-10.00], p=0.007). Among all patients with LL, there were significantly more who developed them before LESCL than those who developed them after LESCL (p<0.001) or at the same time (p=0.008). The mean time before the appearance of LESCL was 9.0months (2-35months) in the 'LL-first' group, which was shorter than that in the control group (12months [1-60months], p=0.010). The rate of positivity for anti-aquaporin 4 IgG antibodies was higher in patients with LL compared with controls (90.24% vs. 64.71%, p=0.002).
LL may be a precursor to LESCL and assist early diagnosis of neuromyelitis optica and longitudinally extensive transverse myelitis.
探讨中国视神经脊髓炎或长节段横贯性脊髓炎患者中线性病灶（LL）与长节段脊髓病灶（LESCL）发生之间的关系。
回顾了143例患有这些疾病的患者的临床记录。41例有LL的患者根据LL和LESCL出现的先后顺序分为三组（同时出现[n = 10]、LL先出现[n = 26]或LESCL先出现[n = 5]）。其余102例无LL的患者作为对照组。
LL先出现的患者年化复发率低于同时出现组（1.00[0.23 - 10.00]对4.38[0.60 - 6.67]，p = 0.017）和对照组（1.00[0.23 - 10.00]对2.00[0.24 - 10.00]，p = 0.007）。在所有有LL的患者中，LL在LESCL之前出现的患者明显多于在LESCL之后出现的患者（p < 0.001）或同时出现的患者（p = 0.008）。“LL先出现”组中LESCL出现前的平均时间为9.0个月（2 - 35个月），短于对照组（12个月[1 - 60个月]，p = 0.010）。与对照组相比，有LL的患者抗水通道蛋白4 IgG抗体阳性率更高（90.24%对64.71%，p = 0.002）。
LL可能是LESCL的前驱病变，有助于视神经脊髓炎和长节段横贯性脊髓炎的早期诊断。
