在向二级进展性多发性硬化症过渡期间的诊断不确定性：阿根廷的多中心研究。
Diagnostic uncertainty during the transition to secondary progressive multiple sclerosis: Multicenter study in Argentina.
机构信息
Centro de Esclerosis Múltiple de Buenos Aires, Buenos Aires, Argentina/Servicio de Neurología, Hospital Universitario CEMIC, Buenos Aires, Argentina.
Centro de Esclerosis Múltiple de Buenos Aires, Buenos Aires, Argentina/Servicio de Neurología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
出版信息
Mult Scler. 2021 Apr;27(4):579-584. doi: 10.1177/1352458520924586. Epub 2020 Jun 2.
BACKGROUND
A period of diagnostic uncertainty often characterizes the clinical transition from relapsing to secondary progressive multiple sclerosis (SPMS).
OBJECTIVE
The aim of this study was to describe the length of time required to reclassify relapsing-remitting MS (RRMS) patients who have clinically transitioned to SPMS (diagnosis uncertainty).
METHODS
This is a retrospective multicenter cohort study conducted in Argentina, identifying in every center all patients with diagnosis of MS who transitioned from RRMS to SPMS during the follow-up. We identified the dates of the last definitive RRMS and first definitive SPMS diagnoses for diagnostic uncertainty. The time required to reclassify RRMS who transitioned to SPMS and the time from disease onset to reclassify SPMS were calculated using the Kaplan-Meier method.
RESULTS
A total of 170 patients were included, where the mean age at disease onset (first symptom) was 36 ± 6 years; the length of time required to reclassify RRMS patients who transitioned to SPMS was 3.3 ± 1.1 years (range = 1-7 years); and the time from disease onset to classify SPMS was 19.4 ± 8.5 years (range = 16-35 years).
CONCLUSION
A period of diagnostic uncertainty regarding the transition from RRMS to SPMS was present in many of our patients, with a mean time of 3.3 years.
背景
从复发缓解型多发性硬化症（RRMS）向继发进展型多发性硬化症（SPMS）的临床转变通常存在一段诊断不确定期。
目的
本研究旨在描述已经发生临床转变为 SPMS（诊断不确定）的 RRMS 患者重新分类所需的时间。
方法
这是一项在阿根廷进行的回顾性多中心队列研究，在每个中心确定所有在随访期间从 RRMS 转变为 SPMS 的 MS 诊断患者。我们确定了诊断不确定时的最后一次明确 RRMS 和首次明确 SPMS 诊断的日期。使用 Kaplan-Meier 方法计算转变为 SPMS 的 RRMS 重新分类所需的时间以及从发病到重新分类 SPMS 的时间。
结果
共纳入 170 例患者，疾病发作（首发症状）时的平均年龄为 36±6 岁；转变为 SPMS 的 RRMS 患者重新分类所需的时间为 3.3±1.1 年（范围为 1-7 年）；从发病到分类为 SPMS 的时间为 19.4±8.5 年（范围为 16-35 年）。
结论
我们的许多患者在从 RRMS 向 SPMS 转变过程中存在诊断不确定期，平均时间为 3.3 年。
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