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视神经脊髓炎谱系疾病疾病复发率相关因素。

Factors associated with disease relapse rate in the Neuromyelitis optica spectrum disorder.

机构信息

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

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

出版信息

Int J Neurosci. 2024 Oct;134(10):1114-1119. doi: 10.1080/00207454.2023.2238245. Epub 2023 Jul 26.

Abstract

BACKGROUND AND OBJECTIVES

Neuromyelitis optica spectrum disorder (NMOSD) is a group of demyelinating diseases of the nervous system with high relapse rate and high disability rate without treatment, and we aimed to explore the influencing factors related to the recurrence of NMOSD and provide basis for clinical treatment in this study.

METHODS

Referring to the diagnostic criteria for NMOSD issued in 2015, 259 patients were enrolled. Clinical information, cerebrospinal fluid (CSF) and serum analysis results, brain and spinal cord magnetic resonance imaging (MRI) findings, treatment details, and prognosis were all recorded.

RESULTS

176 (68.00%) participants were found to be AQP4 Ab-positive in serum or CSF, and the relapse rate was 36.67% (95/259). These 259 individuals were separated into two groups: non-release ( = 164) and relapse ( = 95). In terms of EDSS scores at onset, EDSS score after treatment, lesion location, serum creatinine (Cr) and treatment strategy, there were statistical differences between the two groups. Multivariable logistic regression analyses revealed five predictors for recurrence of NMOSD patients within two years: EDSS scores at onset, transverse myelitis, brain/brainstem, Cr, and Rituximab/immunosuppressants.

CONCLUSION

It is essential to explore the risk factors related to recurrence and prevent them to reduce the risk of disability and improve the prognosis, and the recurrence rate of NMOSD may be affected by several factors.

摘要

背景与目的

视神经脊髓炎谱系疾病(NMOSD)是一组神经系统脱髓鞘疾病,其具有较高的复发率和残疾率,未经治疗的情况下,后果严重。本研究旨在探讨 NMOSD 复发的相关影响因素,为临床治疗提供依据。

方法

参考 2015 年发布的 NMOSD 诊断标准,纳入 259 例患者。记录其临床资料、脑脊液(CSF)和血清分析结果、脑脊髓磁共振成像(MRI)检查结果、治疗细节及预后等。

结果

血清或 CSF 中发现 AQP4 Ab 阳性的患者有 176 例(68.00%),复发率为 36.67%(95/259)。259 例患者分为两组:未缓解组(n=164)和复发组(n=95)。两组患者在起病时的 EDSS 评分、治疗后的 EDSS 评分、病变部位、血清肌酐(Cr)和治疗方案方面存在统计学差异。多变量逻辑回归分析显示,NMOSD 患者在两年内复发的五个预测因素为:起病时的 EDSS 评分、横贯性脊髓炎、脑/脑干、Cr 和利妥昔单抗/免疫抑制剂。

结论

探讨 NMOSD 复发的相关危险因素并加以预防,降低残疾风险,改善预后至关重要,NMOSD 的复发率可能受到多种因素的影响。

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