视神经脊髓炎的临床特点及预后分析

Analysis of Clinical Features and Prognosis of Optical Neuromyelitis

目的对视神经脊髓炎的临床特点及预后展开分析研究。方法以该院2010年4月—2015年的5月期间的7例视神经脊髓炎患者为研究对象,以回顾性分析的方法对患者的临床表现、实验室及影象学检查、治疗及其预后展开分析。结果 7例患者之前从未患过视神经脊髓炎,其中男性5例,女性2例,起病年龄为1~15岁,病前有相关感染史的为5例;第一次犯病临床表现为视神经炎的患者3例,脊髓炎患者4例,视神经炎与脊髓炎间隔时间为1 d^7个月;单侧视神经炎患者2例,双侧视神经患者5例;脊髓横贯性损害患者5例,非横贯性损害患者2例;VEP检查异常患者7例;脊髓MRI检查胸段病灶患者7例;抗体检查异常患者1例。在治疗过程中,除了一名患者不想继续接受治疗外,其余患者的病情均有所好转。有4例患者愿意接受随访调查,其中有两名患者病情复发。结论视神经脊髓炎患者中,儿童患者可于幼儿期发病,患者治疗后可能出现复发现象,应注意复审及跟踪随访。

Objective To analyze and research the clinical features and prognosis of optical neuromyelitis.Methods 7 cases of patients with optical neuromyelitis in our hospital from April 2010 to May 2015 were selected as the research objects and the clinical manifestations,laboratory and imaging examination and treatment and its prognosis were reviewed and analyzed.Results 7 cases of patients had never suffered from optical neuromyelitis,including 5 males and 2 females,and the onset age was from 1~15,and 5 cases had the relevant infection history,and there were 3 cases whose clinical manifestation of the first disease was optical neuromyelitis and 4 cases whose clinical manifestation of the first disease was myelitis,and the interval time of optical neuromyelitis and myelitis was 1d^7 months,and there were 2 cases with unilateral neuropapillitis,5 cases with bilateral neuropapillitis,5 cases with transverse injury of spinal cord,2 cases with non-transverse injury,7 cases with abnormal VEP examination,7 cases with chest lesion examined by the spinal cord MRI and 1 case with abnormal antibody,in the treatment course,the other cases were improved expect for one case that did not receive the treatment,and 4 cases were glad to accept the follow-up examination,and two cases reoccurred.Conclusion The diseases of optical neuromyelitis?children in infancy attack,and the patients may reoccur after treatment,and we should pay attention to review and follow-up.