UBC Hospital, Division of Neurology, Faculty of Medicine and The Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada/School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
UBC Hospital, Division of Neurology, Faculty of Medicine and The Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.
Mult Scler. 2021 Feb;27(2):290-302. doi: 10.1177/1352458520908163. Epub 2020 Apr 6.
There is increasing evidence of prodromal multiple sclerosis (MS).
The aim of this study was to determine whether fatigue, sleep disorders, anaemia or pain form part of the MS prodrome.
This population-based matched cohort study used linked administrative and clinical databases in British Columbia, Canada. The odds of fatigue, sleep disorders, anaemia and pain in the 5 years preceding the MS cases' first demyelinating claim or MS symptom onset were compared with general population controls. The frequencies of physician visits for these conditions were also compared. Modifying effects of age and sex were evaluated.
MS cases/controls were assessed before the first demyelinating event (6863/31,865) or MS symptom onset (966/4534). Fatigue (adj.OR: 3.37; 95% CI: 2.76-4.10), sleep disorders (adj.OR: 2.61; 95% CI: 2.34-2.91), anaemia (adj.OR: 1.53; 95% CI: 1.32-1.78) and pain (adj.OR: 2.15; 95% CI: 2.03-2.27) during the 5 years preceding the first demyelinating event were more frequent among cases, and physician visits increased for cases relative to controls. The association between MS and anaemia was greater for men; that between MS and pain increased with age. Pre-MS symptom onset, sleep disorders (adj.OR: 1.72; 95% CI: 1.12-2.56) and pain (adj.OR: 1.53; 95% CI: 1.32-1.76) were more prevalent among cases.
Fatigue, sleep disorders, anaemia and pain were elevated before the recognition of MS. The relative anaemia burden was higher in men and pain more evident among older adults.
越来越多的证据表明多发性硬化症（MS）存在前驱期。
本研究旨在确定疲劳、睡眠障碍、贫血或疼痛是否构成 MS 前驱期的一部分。
本基于人群的匹配队列研究使用了加拿大不列颠哥伦比亚省的关联行政和临床数据库。在 MS 病例首次脱髓鞘性疾病或 MS 症状发作前 5 年内，比较了疲劳、睡眠障碍、贫血和疼痛的发病几率，并与一般人群对照进行比较。还比较了这些病症的就诊频率。评估了年龄和性别对其的影响。
MS 病例/对照在首次脱髓鞘事件（6863/31865）或 MS 症状发作前（966/4534）进行评估。在首次脱髓鞘事件前 5 年内，疲劳（adj.OR: 3.37; 95% CI: 2.76-4.10）、睡眠障碍（adj.OR: 2.61; 95% CI: 2.34-2.91）、贫血（adj.OR: 1.53; 95% CI: 1.32-1.78）和疼痛（adj.OR: 2.15; 95% CI: 2.03-2.27）在病例中更为常见，且病例的就诊频率相对于对照组增加。MS 与贫血的相关性在男性中更大；MS 与疼痛的相关性随着年龄的增加而增加。在 MS 症状发作前，睡眠障碍（adj.OR: 1.72; 95% CI: 1.12-2.56）和疼痛（adj.OR: 1.53; 95% CI: 1.32-1.76）在病例中更为常见。
疲劳、睡眠障碍、贫血和疼痛在 MS 确诊前就已经升高。男性的相对贫血负担更高，而老年人的疼痛更为明显。
