【摘要】：目的:分析水通道蛋白4抗體(AQP4-IgG)陽(yáng)性與陰性視神經(jīng)脊髓炎譜系疾病(NMOSD)患者的臨床特點(diǎn)及復(fù)發(fā)影響因素。方法:選取2013年1月至2016年10月于我院神經(jīng)內(nèi)科診治并符合2015年IPND制定的診斷標(biāo)準(zhǔn)的NMOSD患者58例,根據(jù)AQP4抗體血清學(xué)或腦脊液結(jié)果分為AQP4抗體陽(yáng)性組與AQP4抗體陰性組,采用卡方檢驗(yàn)、Mann-Whitney U檢驗(yàn)分析兩組患者的臨床特點(diǎn),采用重復(fù)測(cè)量方差分析及多因素Logistic回歸分析進(jìn)行復(fù)發(fā)及復(fù)發(fā)相關(guān)因素分析。結(jié)果:AQP4抗體陽(yáng)性組和AQP4抗體陰性組在年發(fā)作次數(shù)、同時(shí)累及頸胸髓、脊髓受累≥6節(jié)段差異具統(tǒng)計(jì)學(xué)意義(P0.05)。Logistic回歸分析顯示AQP4抗體陽(yáng)性(P=0.000,OR=0.137,95%CI=0.087~0.215)、脊髓受累≥6節(jié)段(P=0.000,OR=2.369,95%CI=1.899~2.955)與NMOSD發(fā)病1年內(nèi)復(fù)發(fā)相關(guān);前驅(qū)感染(P=0.013,OR=0.438,95%CI=0.347~0.553)、AQP4抗體陽(yáng)性(P=0.000,OR=2.103,95%CI=1.648~2.683)、脊髓受累≥6節(jié)段(P=0.002,OR=2.620,95%CI=2.090~3.284)與NMOSD發(fā)病3年內(nèi)復(fù)發(fā)相關(guān)。結(jié)論:AQP4抗體陽(yáng)性NMOSD患者年發(fā)作次數(shù)及脊髓受累≥6節(jié)段較陰性患者多,而AQP4抗體陰性患者更易同時(shí)累及頸胸髓。AQP4抗體陽(yáng)性及脊髓受累≥6個(gè)節(jié)段、前驅(qū)感染為預(yù)測(cè)NMOSD復(fù)發(fā)的獨(dú)立危險(xiǎn)因素。
[Abstract]:Objective: to analyze the clinical characteristics and recurrence factors of (NMOSD) patients with aquaporin-4 antibody (AQP4-IgG) positive and negative. Methods: from January 2013 to October 2016, 58 NMOSD patients who were diagnosed and treated in our department of neurology from January 2013 to October 2016 and who met the diagnostic criteria established by IPND in 2015 were divided into two groups according to the results of AQP4 antibody serology or cerebrospinal fluid (CSF): AQP4 antibody positive group and AQP4 antibody negative group. The clinical features of the two groups were analyzed by chi-square test and Mann-Whitney U test. Recurrence and recurrence related factors were analyzed by repeated measurement variance analysis and multivariate Logistic regression analysis. Results the number of episodes in the positive group and the negative group of AQP4 antibody were the same as the cervical and thoracic spinal cord at the same time. Logistic regression analysis showed that AQP4 antibody was positive (P < 0. 137) and spinal cord involvement 鈮，

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