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[慢性复发性炎性视神经病变的临床特征]

[Clinical features of chronic relapsing inflammatory optic neuropathy].

作者信息

Meng C, Lai C T, Yang Q L, Liu L, Wang J W

机构信息

Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2018 Feb 6;98(6):450-453. doi: 10.3760/cma.j.issn.0376-2491.2018.06.011.

Abstract

To explore the clinical characteristics and prognosis of chronic relapsing inflammatory optic neuropathy (CRION). A retrospective analysis was conducted. Clinical features, disease course, prognosis and magnetic resonance imaging (MRI) of patients with CRION who were admitted to Department of Neurology between 2014 and 2016 were reviewed and analyzed. Totally, there were 27 patients (10 males and 17 females), with an age range of 17-59 years. The disease duration was between 40 days and 8 years. There were 2 to 9 CRION episodes. The mean frequency of CRION episodes was 3.30±1.56. The outcome of visual acuity showed that the more episodes frequency was, the worse outcome became. There was 25 abnormal optic nerve signals in MRI. And in 22 cases, the abnormal signals were in intraorbital segment or inner pipe section. The antinuclear antibodies (ANA) titers were elevated in 5 patients. Five cases relapsed during reduction or withdrawal of steroids, but steroids was not added in time. The final outcome of these 5 patients was poor. CRION was more common in female than male patients. Most patients were companied by pain, and the lesions were more common in the intraorbital segment of optic nerve. The more episode frequency was, the worse prognosis became. If a relapse happened, steroids or other immunosuppressive agents should be used.

摘要

探讨慢性复发性炎性视神经病变(CRION)的临床特征及预后。进行回顾性分析。对2014年至2016年期间神经内科收治的CRION患者的临床特征、病程、预后及磁共振成像(MRI)进行回顾分析。共有27例患者(男10例,女17例),年龄范围为17至59岁。病程为40天至8年。CRION发作2至9次。CRION发作的平均频率为3.30±1.56。视力结果显示,发作频率越高,预后越差。MRI检查有25例视神经信号异常。其中22例异常信号位于眶内段或管内段。5例患者抗核抗体(ANA)滴度升高。5例患者在激素减量或停药过程中复发,但未及时加用激素。这5例患者最终预后较差。CRION在女性患者中比男性患者更常见。大多数患者伴有疼痛,病变更常见于视神经眶内段。发作频率越高,预后越差。如果复发,应使用激素或其他免疫抑制剂。

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