临床孤立综合征患者的临床转化率低 - 2010 年 McDonald 标准的诊断获益？
Low clinical conversion rate in clinically isolated syndrome patients - diagnostic benefit of McDonald 2010 criteria?
机构信息
Institut für Neuroimmunologie und Multiple Sklerose, Zentrum für Molekulare Neurobiologie, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
出版信息
Eur J Neurol. 2018 Feb;25(2):247-e9. doi: 10.1111/ene.13476. Epub 2017 Dec 2.
BACKGROUND AND PURPOSE
New diagnostic criteria of multiple sclerosis (MS) increase the number of patients being diagnosed with MS whilst a substantial part might not convert to clinically definite MS (CDMS). The diagnostic accuracy of the McDonald 2005 and 2010 criteria for conversion to CDMS was evaluated in an unselected cohort of patients in whom an MS diagnostic work-up was decided.
METHODS
Clinical, magnetic resonance imaging and cerebrospinal fluid data were analysed for all patients who presented with symptoms suspicious for MS at the university based MS outpatient clinic between 2006 and 2010 (n = 165).
RESULTS
Follow-up was available for 131 patients. During the mean follow-up period of 2 years, 19% of patients developed CDMS whereas 64% of the patients fulfilling McDonald 2010 criteria did not convert to CDMS.
CONCLUSION
The low clinical conversion rate indicates that the new diagnostic criteria may increase the incidence of MS cases with a less active disease course.
背景与目的
多发性硬化症（MS）的新诊断标准增加了被诊断为 MS 的患者数量，而其中相当一部分可能不会发展为临床确诊多发性硬化症（CDMS）。本研究旨在评估麦克唐纳 2005 年和 2010 年标准在未经选择的 MS 门诊患者队列中的诊断准确性，这些患者都进行了 MS 诊断性检查。
方法
对 2006 年至 2010 年期间在大学 MS 门诊就诊、出现疑似 MS 症状的所有患者（n=165）进行了临床、磁共振成像和脑脊液数据的分析。
结果
131 例患者可获得随访。在平均 2 年的随访期间，19%的患者发展为 CDMS，而符合麦克唐纳 2010 年标准的患者中，有 64%未发展为 CDMS。
结论
较低的临床转化率表明，新的诊断标准可能会增加疾病进程不活跃的 MS 病例数量。
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