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描绘多发性硬化症患者的病程:症状概述

Picturing the Multiple Sclerosis Patient Journey: A Symptomatic Overview.

作者信息

Correia Inês, Bernardes Catarina, Cunha Carolina, Nunes Carla, Macário Carmo, Sousa Lívia, Batista Sónia

机构信息

Neurology Department, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra, 3004-561 Coimbra, Portugal.

Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal.

出版信息

J Clin Med. 2024 Sep 25;13(19):5687. doi: 10.3390/jcm13195687.

Abstract

: Multiple sclerosis (MS) presents a wide range of clinical symptoms, historically understood through long-term studies of earlier patient cohorts. However, due to improved diagnostic criteria, modern patients are diagnosed earlier and benefit from effective treatments, altering the disease's natural history. This study aimed to assess the clinical symptoms of MS patients in a modern population at various stages: before diagnosis, at diagnosis, during the disease course, and at the time of the survey. : This was an observational study with retrospective and cross-sectional components; patients that fulfilled the 2017 revised McDonald criteria for MS completed a survey evaluating demographic and clinical data. : We included 163 patients, 69.9% female, with a mean age of 48.21 years; 87.1% had relapsing-remitting MS (RRMS), with a median EDSS of 2.0. Before diagnosis, 74.2% of patients experienced symptoms, mainly sensory issues (39.3%), fatigue (29.4%), and imbalance (27%). Motor and coordination symptoms were more common in progressive forms. At diagnosis, sensory (46.6%) and motor complaints (36.8%) were most prevalent. In RRMS and secondary progressive MS (SPMS), sensory and motor complaints predominated alongside imbalance, while primary progressive MS (PPMS) was characterized by motor, imbalance, and genitourinary symptoms. Throughout the disease, sensory symptoms were most common (76.1%), with fatigue (73%) and motor issues (62.6%) more prevalent in progressive forms. At the time of the survey, 50.7% of RRMS patients were asymptomatic, while progressive patients continued to experience motor symptoms, imbalance, and fatigue. : The study reflects the modern spectrum of MS symptoms, consistent with previous research.

摘要

多发性硬化症(MS)呈现出广泛的临床症状,从历史上看,这是通过对早期患者队列的长期研究来理解的。然而,由于诊断标准的改进,现代患者能够更早被诊断出来,并受益于有效的治疗,这改变了该疾病的自然病程。本研究旨在评估现代人群中MS患者在不同阶段的临床症状:诊断前、诊断时、疾病过程中以及调查时。 :这是一项具有回顾性和横断面成分的观察性研究;符合2017年修订的MS麦克唐纳标准的患者完成了一项评估人口统计学和临床数据的调查。 :我们纳入了163名患者,其中69.9%为女性,平均年龄为48.21岁;87.1%患有复发缓解型MS(RRMS),扩展残疾状态量表(EDSS)中位数为2.0。诊断前,74.2%的患者出现症状,主要是感觉问题(39.3%)、疲劳(29.4%)和失衡(27%)。运动和协调症状在进展型中更为常见。诊断时,感觉症状(46.6%)和运动主诉(36.8%)最为普遍。在RRMS和继发进展型MS(SPMS)中,感觉和运动主诉以及失衡最为突出,而原发进展型MS(PPMS)的特征是运动、失衡和泌尿生殖系统症状。在整个疾病过程中,感觉症状最为常见(76.1%),疲劳(73%)和运动问题(62.6%)在进展型中更为普遍。在调查时,50.7%的RRMS患者无症状,而进展型患者继续经历运动症状、失衡和疲劳。 :该研究反映了MS症状的现代谱,与先前的研究一致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bba/11476823/242a317c00d9/jcm-13-05687-g001.jpg

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