[古巴定义的多发性硬化症患者的临床特征]

[Clinical characterization of patients with multiple sclerosis defined in Cuba].

作者信息

Cabrera-Gómez J A, Santana E, Vals O, Casanova M, Alfaro I, González-Quevedo A, Fernández R, Gómez L, Báez M, Rodríguez A, Quevedo L, Cabrera-Núñez J A

机构信息

Sección de Esclerosis Multiple, Hospital Gustavo Aldereguía Cienfuegos Cuba

出版信息

Rev Neurol. 1998 May;26(153):723-8.

PMID:9634654

Abstract

INTRODUCTION

Since 1975 no studies have been done in Cuba defining the clinical characteristics of patients with multiple sclerosis (MS).

OBJECTIVE

To describe the characteristics of a group of Cuban patients with definite clinical MS.

MATERIAL AND METHODS

Fifty eight patients with definite clinical MS were studied (Poser et al) with normal motor (VCM) and sensory (VCS) conduction velocities. Tests were done on them: clinical scale (Scripps), incapacity (EDSS) and quality of life (Steps), together with various complementary tests. Each patient was classified according to the way in which the disease evolved. Also the two commonest clinical types were compared and we applied the difference test between percentages of non-paired samples with an alfa level of 0.05.

RESULTS

Onset of the illness in most cases was before the age of 40 (86.1%), 75.9% were women and 82.8% were white. In 15.3% there was a family history of MS. In 25.9% there were psychiatric disorders and trigger factors (43.1%. The most frequent initial symptoms were pyramidal (48.3%) sensorial (41.4%) and cerebellar (39.7%). Scripps scale scores were < 80 in 60.2%, in EDSS < 5 (61.9%) and in the Clinical Steps < 3 in 65.4%). Motor potentials (81.9%) somatosensory potential (PESS) (72.3%) and magnetic resonance imaging (MR) (76.4%) were the most abnormal results. Exacerbation-remission (ER) was the most frequent type of evolution (53.4%) generally affecting patients aged under 40 years old (p = 0.02), EDSS < 5 (64.4%), Scripps > 80 (61.2%), Steps < 3 (95.6%), pyramidal system involvement (58.5%), cerebellar (29.2%) and MRI abnormality (80%). The progressive primary form (PP) was the second most frequent (29.3%); 29.4% were under 40 years of age, had more marked changes in all functional system (100%), degree of incapacity and quality of life (100%). PESS (92.5%); the urodynamic tests 58.85%) were less positive on MRI (54.5%) as compared with the ER form.

CONCLUSIONS

The differences found between the clinical forms ER and II indicate that there is greater deterioration in the PP form, probably due to age and more cerebellar and spinal cord involvement.

摘要

引言

自1975年以来，古巴尚未开展有关多发性硬化症（MS）患者临床特征的研究。

目的

描述一组确诊为临床型MS的古巴患者的特征。

材料与方法

对58例确诊为临床型MS（波泽等人标准）且运动（VCM）和感觉（VCS）传导速度正常的患者进行研究。对他们进行了以下测试：临床量表（斯克里普斯）、失能程度（EDSS）和生活质量（Steps），以及各种辅助检查。根据疾病的发展方式对每位患者进行分类。此外，对两种最常见的临床类型进行了比较，并应用非配对样本百分比差异检验，α水平为0.05。

结果

大多数患者发病年龄在40岁之前（86.1%），75.9%为女性，82.8%为白人。15.3%有MS家族史。25.9%有精神障碍和诱发因素（43.1%）。最常见的初始症状为锥体束征（48.3%）、感觉障碍（41.4%）和小脑征（39.7%）。斯克里普斯量表评分<80的占60.2%，EDSS<5的占61.9%，临床Steps<3的占65.4%。运动电位（81.9%）、体感诱发电位（PESS）（72.3%）和磁共振成像（MR）（76.4%）异常结果最为常见。缓解-复发型（ER）是最常见的疾病发展类型（53.4%），通常影响40岁以下患者（p = 0.02），EDSS<5（64.4%），斯克里普斯>80（61.2%），Steps<3（95.6%），锥体系统受累（58.5%），小脑受累（29.2%），MRI异常（80%）。原发进展型（PP）是第二常见类型（29.3%）；29.4%年龄在40岁以下，所有功能系统变化更明显（100%），失能程度和生活质量变化更明显（100%）。与ER型相比，PESS（92.5%）；尿动力学检查（58.85%）在MRI上阳性率较低（54.5%）。