脊髓型和传统型多发性硬化症患者激素治疗临床转归.docVIP

脊髓型和传统型多发性硬化症患者激素治疗临床转归 　　[摘要] 目的：总结分析脊髓型多发性硬化与传统型多发性硬化的临床特点及激素在缓解期的治疗。方法：回顾分析28例多发性硬化患者临床症状、复发次数、MRI表现及缓解期激素治疗情况。结果：多发性硬化患者以女性居多，典型多发性硬化好发年龄在20~40岁（69.23%），脊髓型多发性硬化好发年龄在30~50岁（86.66%）；本组中脊髓型多发性硬化占多发性硬化的大部分（53.57%），脊髓型多发性硬化以颈、胸髓部位病变常见；常规激素治疗脊髓型多发性硬化复发次数明显高于典型多发性硬化。结论：脊髓型多发性硬化常规减停激素治疗复发率较高。 　　[关键词] 多发性硬化；脊髓型；皮质类固醇；回顾性分析 　　[中图分类号] R593.2 [文献标识码] B [文章编号] 1673-7210（2011）07（a）-167-02 　　 　　Hormone therapy for clinical outcomes in spinal type and conventional multiple sclerosis 　　ZHANG Huimin1, LIANG Zhanhua1, LI Li2, ZHAO Hang1 　　1.The First Affiliated Hospital of Dalian Medical University, Dalian 116011,China;2.Dalian Locomotive Hospital, Dalian 116011,China 　　[Abstract] Objective: To explore the difference on clinical features between spinal type and conventional multiple sclerosis (MS) and to study the significance of corticosteroid in remission treatment. Methods: According to the retrospective analysis of the 28 cases of MS patients, the clinical manifestation, recurrence rate,magnetic resonance imaging(MRI), remission of corticosteroids in the treatment results were studied. Results: The patient of MS were female in the majority. The predilection age of conventional MS was 30-50 years old (86.66%); spinal type MS tooe majority in MS (53.57%),cervical and thoracic spinal cord were the usual sites; the recurrence rate of conventional MS was lower than spinal type MS. Conclusion: The recurrence rate is higher in spinal type MS when patient are treated with routine hormone. 　　[Key word] Multiple sclerosis; Spinal type; Corticosteroid; Retrospective analysis 　　 　　多发性硬化（multiple sclerosis，MS）是以中枢神经系统白质炎症性脱髓鞘为主要表现的自身免疫性疾病，临床特点存在着时间、空间多发性，临床症状多种多样，而我国MS患者又有着自己的特点。我国MS最常见症状是视神经症状，病程中最常累及的部位为脊髓[1]。近年仅以脊髓病灶为主引起临床表现的MS即脊髓型MS报道较多。 　　1 资料与方法 　　1.1 资料来源及诊断标准 　　收集2009年1~12月大连医科大学附属第一医院神经内科住院，临床确诊的多发性硬化患者共28例，其中女性19例，男性9例，起病年龄为12~61岁。其中脊髓受累者18例，以脊髓损害为临床表现的MS即脊髓型MS为15例，占53.57%，女性12例，男性3例，其中30~50岁高发（86.66%），平均首发年龄41.5岁。以颅内症状为首发者即传统型MS13例，占46.43%，女性7例，男性6例，平均年龄34.4岁，20~