多发性硬化的诊断及治疗研究进展

Progress in the diagnosis and treatment of multiple sclerosis

多发性硬化(multiple sclerosis,MS)是一种慢性的免疫介导的中枢神经系统疾病,全球范围发病率逐年上升,但儿童发病率相对较低。目前认为MS是由环境和基因共同致病,但具体病因尚不明确。该病具有时间多发性及空间多发性的特点,第一次发病后病理状态持续存在,治疗也需持续进行,甚至终身。为更早地发现及诊断MS,2017年再次修订了McDonald MS诊断标准。近几年已相继研发出多种治疗药物,有部分药品针对儿童做出剂量指导,但儿童用药仍为超说明书用药。该文对MS流行病学、病因、临床表现、病理等方面作一介绍,并重点对诊断和治疗现状作一综述。

Multiple sclerosis is a chronic immune-mediated disease of the central nervous system.There is increasing incidence of MS globally,and the incidence of pediatric MS is relatively low.Environment and genetics both contribute to the causes of MS,while the specific etiology is unknown.MS is characterized by dissemination in time(DIT)and dissemination in space(DIS).Pathology is progressive since first attack,and the treatment is progressive even for a lifetime.The McDonald MS criteria was revised again in 2017 for diagnosing this disease earlier.Several drugs have been developed in recent years,and some drugs have guide of children dosage.However,treatment for children is still off-label.This article introduces the epidemiology,etiology,clinical presentation and pathology of MS.