83例多发性硬化诊治分析.docVIP

83例多发性硬化诊治分析 　　[摘要] 目的 探讨多发性硬化（MS）的诊治情况。 方法 回顾性分析McDonald诊断标准确诊的83例MS患者的临床资料，对临床表现、病变部位、病程分型、治疗预后进行综合分析。 结果 83例MS患者中，受凉和上呼吸道感染为最常见诱因，常见临床症状依次为运动障碍、感觉障碍、视力减退。MRI和诱发电位检查是最重要的辅助检查手段，病变累及部位以大脑最常见，其次为脊髓和视神经。复发-缓解型最多。经治疗，有效80例，无效3例，有效率为96.4%。 结论 萍乡地区是MS低患病率地区，结合临床特点、MRI、脑脊液免疫学、诱发电位检查能明显提高临床确诊率，及早进行有效的治疗可干预病情进展，降低致残率。 　　[关键词] 基层医院；多发性硬化；诊治 　　[中图分类号] R744.5+1 [文献标识码] B [文章编号] 1674-4721（2013）11（a）-0174-03 　　The diagnosis and treatment of multiple sclerosis in 83 cases 　　ZHENG Xiao-dong 　　Department of Neurology，People′s Hospital of Pingxiang City in Jiangxi Province，Pingxiang 337000，China 　　[Abstract] Objective To explore the diagnosis and treatment of multiple sclerosis （MS）.Methods The clinical data of 83 patients with MS diagnosed by McDonald standard were retrospectively analyzed，including the clinical manifestation，pathological changes，the course classification，treatment and prognosis.Results Of the total 83 MS patients，cold catching and upper respiratory tract infection were the most common inducing factors，the three most common clinical symptoms included movement dysfunction，sensory dysfunction and decreased visual acuity.MRI and evoked potential were the most important auxiliary examination tools.Brain was the most common area involed，followed by spinal cord，and optic nerve.Relapsing-remitting was the most common type.After treatment，there were 80 cases of efficacy，3 cases of invalid，the efficacy was 96.4%.Conclusion Pingxiang city is a place of low prevalence of multiple sclerosis.The combination of clinical features，MRI，cerebrospinal fluid，immunology，and evoked potential examination can significantly increase the rate of definite diagnosis.Early treatment can effectively intervene the progression of disease and reduce morbidity. 　　[Key words] Grassroots hospital；Multiple sclerosis；Diagnosis and treatment 　　多发性硬化（multiple sclerosis，MS）是常见的慢性神经系统疾病，病因和发病机制至今尚未完全明确，现有的治疗均不能延缓疾病的进程。本文对83例MS患者的临床资料进行归纳、总结，旨在总结出萍乡地区MS的临床特点以提高对该病的诊治水平。 　　1 资料与方法 　　1.1 研究对象