晚发型视神经脊髓炎谱系疾病三者的临床特征

Clinical features of late-onset neuromyelitis optica spectrum disorders

目的研究晚发型视神经脊髓炎谱系疾病（LONMOSD）患者的临床特征。方法收集2014-年1月至2017年5月于海军总医院住院治疗的28例LONMOSD和同期住院的51例早发型视神经脊髓炎谱系疾病（EONMOSD）患者的临床资料并进行门诊或电话随访，比较二组患者的临床表现、实验室检查及影像学特征。结果（1）LONMOSD组患者起病的年龄是（59±6）岁，女24例（85．7％）；（2）LONMOSD组患者前驱感染史较EONMOSD组患者少见（14．3％比37．3％，P〈0．05），并发其他疾病比较多见（53．6％比5．9％，P〈0．05）；（5）LONMOSD组患者首发症状为横贯性脊髓炎（TM）者较EONMOSD组少见（39．3％比64．7％，P〈0．05）；（4）两组患者急性期及缓解期EDSS评分、实验室及影像学检查结果差异无统计学意义。结论LONMOSD患者较少有前驱感染史，首发症状表现为TM者较EONMOSD患者少见。

Objective To study the clinical features of late-onset neuromyelitis optica spectrum disorders（LONMOSD）. Methods Twenty-eight patients with LONMOSD and fifty-one patients with early- onset neuromyelitis optica spectrum disorders （EONMOSD） hospitalized in Navy General Hospital from January 2014 to May 2017 were enrolled and were followed up by telephone or outpatient visiting. The clinical manifestations, laboratory examinations and imaging features of the two groups were compared. Results （ 1 ） The average age of onset in group LONMOSD was （59 ＋ 6） years old, and 24 cases were female（ 85.7% ）. （2） The history of prodromal infection in LONMOSD patients was less reported than that in group EONMOSD （14. 3 vs 37.3%, P 〈 0.05 ）, but concomitant diseases were more common in LONMOSD patients（53.6% vs 3.9%, P 〈0.05）. （3） In group of LONMOSD, the patients with transverse myelitis（TM ）as the first symptom were less than that of EONMOSD group （39. 3% vs 64. 7% , P 〈0. 05）. （4） There was no significant difference in EDSS score either in acute or remission stage, laboratory and imaging findings between the two groups. Conclusion Patients with LONMOSD have less history of Drodromal infection, and those with TM as the first symptom are less than EONMOSD patients.