孤立综合征转化为多发性硬化影响因素分析

Influential factors for evolvement of multiple sclerosis in patients with clinically isolated syndrome

目的探讨临床孤立综合征(CIS)转化为临床确诊的多发性硬化(CDMS)的影响因素。方法收集就诊某医院神经内科2000-2007年的123例CIS患者进行随访,终点事件为由CIS转化为CDMS,进行Cox回归分析。结果 123例CIS患者中有48例转化为CDMS,Cox回归分析结果显示,对CIS转化为CDMS差异有统计学意义的影响指标为病前有诱因是无诱因的2.6倍(95%CI=1.19～5.68,P=0.02);首发季节为夏天是冬天的5.48倍,(95%CI=1.84～16.34,P=0.002);首发季节为春天是冬天的4.01倍(95%CI=1.16～13.89,P=0.03);低尿酸水平是高尿酸水平的0.98倍(95%CI=0.97～0.99,P=0.01);尚不能认为乙肝表面抗体和首次发病静脉用丙种球蛋白对CIS转化为CDMS差异有统计学意义。结论病前有诱因、首次发病季节为夏季和春季有可能促进CIS向CDMS的转化。

Objective To explore influential factors for the evolvement from clinically isolated syndromes（CIS） into clinical definite multiple sclerosis（CDMS）.Methods Totally 123 CIS inpatients in a hospital from 2000 to 2007 were recruited and interviewed to collect information on outcome of the disease and the incidence of CDMS.Cox survival analysis was adopted in data analysis.Results Among the 123 CIS patients,48 evolved into CDMS.Cox multivariate analysis showed that significant risk factors for the evolvement of CDMS among the CIS patients were with inducement before the incidente of CIS（relative risk[RR]= 2.6,95% confidence interval[CI]= 1.19-5.68,P = 0.02）,first onset of CIS in summer（compared to the onset in winter：RR = 5.48,95% CI = 1.84-16.34,P = 0.002）,first onset of CIS in spring（compared to the onset in winter：RR = 4.01,95% CI = 1.16-13.89,P = 0.03）.Conclusion The inducement before the incidence of CIS,first onset of CIS in summer or in winter may be risk factors for evolvement CDMS in patients with CIS.