视神经脊髓炎谱系疾病一般临床特征和神经系统外表现研究

Study of General Clinical Features and Extraneural Manifestations of Neuromyelitis Optica Spectrum Disorders

目的:研究视神经脊髓炎谱系疾病(NMOSDs)的一般临床特点、神经系统外表现,并分析可能影响复发的临床因素。方法:回顾性收集NMOSDs患者55例为NMOSDs组,健康体检者36例为对照组,主要记录血常规、肾功能、肌酸激酶等指标、AQP4-Ab状态以及相关影像学检查结果,记录首发核心症状、复发次数等临床特征。结果:NMOSDs好发于中青年女性,男女比例1∶10,男女发病年龄之间并无明显差异。2组在中性粒细胞计数、淋巴细胞计数、中性粒细胞/淋巴细胞比值(NLR)、预估肾小球率过滤、肌酸激酶等指标之间差异均有统计学意义(P<0.05)。1年内复发次数的多少在性别、AQP4-Ab状态、颅内受累情况以及病灶范围等临床指标之间的差异均无统计学意义(P>0.05)。结论:除常见神经系统症状外,NMOSDs患者可能还会出现骨骼肌等外周组织器官受累。中性粒细胞计数、淋巴细胞计数、NLR等指标可反映疾病炎症状态。性别、AQP4-Ab、颅内受累情况以及病灶范围不影响NMOSDs复发次数。

Objective:To study the general clinical features and extraneural manifestations of neuromyelitis optica spectrum diseases(NMOSDs),and to analyze clinical factors that may affect recurrence.Methods:The NMOSDs group and control group cases were retrospectively enrolled,and routine blood work,renal function,creatine kinase,and other indicators were recorded.AQP4-Ab status,related imaging examination results,initial core symptoms,number of relapses,and other clinical features were recorded by a professional neurologist.Results:NMOSDs were more common in young and middle-aged women,with a male to female ratio of 1∶10,and there was no significant difference between the age of onset in males and females.The NMOSDs group and control group had statistical differences in neutrophil count,lymphocyte count,neutrophil/lymphocyte ratio(NLR),estimated glomerular rate filtration,and creatine kinase(P<0.05).There was no statistically significant difference in the number of recurrences in 1 year among clinical indicators such as gender,AQP4-Ab status,intracranial involvement,and lesion range(P>0.05).Conclusion:In addition to common neurological symptoms,patients with NMOSDs may also experience symptoms of the skeletal muscles and other peripheral tissues and organs.The neutrophil count,lymphocyte count,NLR,and other indicators can reflect the inflammatory state of the disease.Gender,AQP4-Ab,intracranial involvement,and the extent of the lesion do not affect the number of recurrences of NMOSDs.