视神经炎发展为多发性硬化的危险因素分析

Prognostic factors of MS after optic neuritis

目的:分析视神经炎发展为多发性硬化(multiple sclerosis,MS)的危险因素。方法:对比分析6例发展为MS的视神经炎患者和其余45例视神经炎患者的临床资料,寻找视神经炎发展为多发硬化的危险因素。结果:发展为MS的视神经炎复发率比其他视神经炎高(P<0.01),眼球周围疼痛较其他视神经炎多见,但无统计学意义(P=0.18)。性别、年龄、单侧或双侧发病、视力下降程度、视盘水肿等方面均未见明显差异。血沉高于正常的视神经炎患者较血沉正常的患者更不易发展为MS(P<0.05)。结论:对于复发的、存在眼球周围疼痛的视神经炎患者要重点关注其发展为MS的可能。视神经炎患者应常规行血沉检查。最好以头颅MRI检查替代头颅CT检查,条件允许时检查脊髓MRI。

AIM： To explore the prognostic factors for the develop- ment of multiple sclerosis （MS） following optic neuritis. METHODS： We followed in a retrospective study （2003- 2006） of 51 patients with optic neuritis. Six of them were verified MS at last. RESULTS. Recurrence of MS optic neuritis elevated the risk significantly （ P 〈 0.01 ）. The pain around eyes was more common than other optic neuritis, but it had no statistical significance （ P = 0.18 ）. There were no signifi- cant differences on sex, age, one/double side occurrence, decrease degree of visual acuity, and papilloedema etc. Erythrocyte sedimentation rate （ESR） was associated with a lower risk of multiple sclerosis. CONCLUSION： The risk of MS in this large population- based prospective ON patient series is 12% and significantly higher in those which recurrence. ESR is recommended to be examined at onset.