中国同心圆硬化72例临床特点分析

Clinical features of Balo's concentric sclerosis in 72 Chinese patients

目的了解我国同心圆硬化患者的临床特点。方法检索维普电子期刊全文数据库1989年-2015年间收录的同心圆硬化病例报告文献,并分析所报道病例的临床特点。结果共纳入46个相关研究,包括72例患者,其中男性35例,女性37例,发病年龄最小为17岁,最大63岁,平均发病年龄为(37.88±9.85)岁。2例发病前有疫苗接种史,另2例发病前有"感冒"前驱感染史。53例(73.61%)患者以运动障碍为首发症状,19例以头痛、头晕或言语不利等为首发症状。52例患者进行了脑脊液检查,其中30例正常、5例脑脊液压力增高、13例脑脊液蛋白增高、10例脑脊液寡克隆区带(OB)阳性。同心圆硬化病灶累及部位最多见于额叶,其余累及部位还包括顶叶及半卵圆中心等。大多数均为多发病灶,仅3例为单发病灶。个别同心圆硬化可伴随甲状腺功能减退(2例)与周围神经损害(1例)。结论中国同心圆硬化以中青年常见,男女发病无明显差异,大多数无诱发因素,常见首发症状包括肢体障碍、头晕、头痛,实验室检查常无明显异常,脑脊液寡克隆区带出现率较低,诊断依赖于头部MRI。

Objective To investigate the clinical features of patients with Balo 5 s concentric sclerosis in China.Methods Cases reports of Balo＇ s concentric sclerosis from 1989 to 2015 were retrieved from the database of Weipu by usingthe key words of “ Balo ’ s concentric sclerosis” , “ Balo desease”. Clinical features of reported patients with Balo＇ s concentricsclerosis were analyzed. Results Forty-six reports were enrolled. Totally,72 patients including 35 males and 37 femaleswere included in the study. The mean onset age was 37.88 ± 9. 85 years old （ range 17 ~ 63 years）. Two cases beforethe onset had the history of vaccination, another 2 cases before the onset had cold precursor infection. There were 53 patients（73.61%） with motor disorders as the initial symptoms, 19 cases with headache,dizziness or inarticulateness as the firstsymptoms. Cerebrospinal fluid examination was performed in 52 cases, including 30 cases of normal,5 cases of cerebrospinalfluid pressure increase,13 cases of cerebrospinal fluid protein increase,10 cases of oligoclonal band（OB） positive. The lesionswere most common in the frontal lobe,and the other parts of the lesions were also included the parietal and semi ovalcenter. Most of the cases were multiple lesions, only 3 cases were single lesions. Individual Balo＇ s concentric sclerosis couldbe accompanied by hypothyroidism （2 cases）. Balo＇ s concentric sclerosis was rarely accompanied by neuropathy （1 case）.Conclusions In China, Balo＇ s concentric sclerosis, common to the young, there was no significant difference between maleand female in both of the morbidity and onset age. Most of them had no predisposing factors. Common first symptoms includedlimb disorders, dizziness, headache, whereas laboratory examination had no obvious abnormality. In cerebrospinal fluid examination,there was a low rate of oligoclonal band（ OB） positive. The diagnosis of this disease was dependent on MRI.