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散发性克雅氏病的流行病学和临床特征:中国东部的一项回顾性研究

Epidemiological and Clinical Characteristics of Sporadic Creutzfeldt-Jakob Disease: A Retrospective Study in Eastern China.

作者信息

Feng Shuo, Zhao Xinjing, Zhou Xueying, Ye Xiang, Yu Xiaolin, Jiang Wei, Deng Yu, Zhou Shengnian, Ma Lin, Shan Peiyan, Zhou Guoyu

机构信息

Department of Neurology, Qilu Hospital of Shandong University, Jinan, China.

Department of Geriatric Neurology, Qilu Hospital of Shandong University, Jinan, China.

出版信息

Front Neurol. 2021 Oct 6;12:700485. doi: 10.3389/fneur.2021.700485. eCollection 2021.

Abstract

We aimed to characterize the epidemiological and clinical characteristics of sporadic Creutzfeldt-Jakob disease (sCJD) in eastern China in this retrospective study. This study enrolled 67 patients with sCJD hospitalized in a grade-A tertiary hospital in eastern China from January 2010 to January 2020. Demographic data, clinical symptoms, brain magnetic resonance imaging (MRI), electroencephalogram (EEG), cerebrospinal fluid (CSF) 14-3-3 protein test, polymerase chain reaction (PCR), and DNA sequence determination of genes were collected and analyzed. There were 62 patients with probable sCJD and 5 patients with possible sCJD. Male (28 cases) to female (39 cases) ratio was 1:1.39. Mean age at disease onset was 64.42 ± 9.00 years (range: 29-88 years), and mean survival time was 9.39 ± 12.58 months (range: 1-60 months for patients who received the follow-ups). The most common onset symptoms were dementia (49.25%), movement disorder (44.78%), and visual disturbance (22.39%), while the most frequent clinical manifestations were language disorders (74.63%), ataxia (70.15%), and myoclonus (70.15%). The positive rates of brain MRI abnormalities, 14-3-3 protein in CSF, and periodic sharp wave complexes (PSWCs) on EEG were 84.90, 68.00, and 46.03%, respectively. The 14-3-3 protein positive ( = 0.033) and PSWCs on EEG ( = 0.020) acted as the favorable and unfavorable factor for over 1 year of survival time, respectively. There were some differences in epidemiological and clinical characteristics among patients in China and those of other countries. The prognosis and its influencing factors were relatively unexplored in China. The mean survival time of Chinese patients was longer than that of Caucasian patients but shorter than that of Japanese patients. The 14-3-3 protein in CSF and PSWCs on EEG were both closely related to the survival time. It is necessary to promote autopsy or biopsy to better understand sCJD in China.

摘要

在这项回顾性研究中,我们旨在描述中国东部散发性克雅氏病(sCJD)的流行病学和临床特征。本研究纳入了2010年1月至2020年1月在中国东部一家三级甲等医院住院的67例sCJD患者。收集并分析了人口统计学数据、临床症状、脑磁共振成像(MRI)、脑电图(EEG)、脑脊液(CSF)14-3-3蛋白检测、聚合酶链反应(PCR)以及基因的DNA序列测定结果。其中有62例可能的sCJD患者和5例疑似sCJD患者。男性(28例)与女性(39例)的比例为1:1.39。发病时的平均年龄为64.42±9.00岁(范围:29 - 88岁),平均生存时间为9.39±12.58个月(接受随访患者的范围:1 - 60个月)。最常见的起病症状为痴呆(49.25%)、运动障碍(44.78%)和视觉障碍(22.39%),而最常见的临床表现为语言障碍(74.63%)、共济失调(70.15%)和肌阵挛(70.15%)。脑MRI异常、CSF中14-3-3蛋白以及EEG上周期性锐波复合波(PSWCs)的阳性率分别为84.90%、68.00%和46.03%。CSF中14-3-3蛋白阳性(P = 0.033)和EEG上出现PSWCs(P = 0.020)分别是生存时间超过1年的有利和不利因素。中国患者与其他国家患者在流行病学和临床特征方面存在一些差异。在中国,预后及其影响因素相对未得到充分研究。中国患者的平均生存时间长于白种人患者,但短于日本患者。CSF中的14-3-3蛋白和EEG上的PSWCs均与生存时间密切相关。在中国,有必要推广尸检或活检以更好地了解sCJD。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f772/8526550/a31fafd0dfb5/fneur-12-700485-g0001.jpg

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