發(fā)布時間：2018-01-22 19:11

  本文關(guān)鍵詞： 特發(fā)性脫髓鞘性視神經(jīng)炎 復(fù)發(fā) 轉(zhuǎn)歸 激素劑量 雙眼視神經(jīng)炎　出處：《廣西醫(yī)科大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：分析引起特發(fā)性脫髓鞘性視神經(jīng)炎(IDON)復(fù)發(fā)的可能因素,為預(yù)防復(fù)發(fā)提供依據(jù)。 方法：采用回顧性研究的方法,收集廣西醫(yī)科大學(xué)第一附屬醫(yī)院在2003年1月至2011年1月間確診為特發(fā)性脫髓鞘性視神經(jīng)炎住院患者的相關(guān)資料,并對其進行隨訪追蹤,了解其復(fù)發(fā)與復(fù)發(fā)有關(guān)的因素,觀察截止日期是2012年1月,對可能引起復(fù)發(fā)的原因進行單因素和多因素的分析。 結(jié)果：本研究最后納入115例特發(fā)性脫髓鞘性神經(jīng)炎的患者,隨訪發(fā)現(xiàn)復(fù)發(fā)32例,未復(fù)發(fā)83例。單因素分析結(jié)果顯示年齡(P=0.453)、患眼初次最佳矯正視力(logMAR)(P=0.962)、性別(P=0.091)、眼痛(P=0.398)、視盤水腫(P=0.098)、激素劑量(P=0.128)、初發(fā)病時是否脫髓鞘(P=0.082)與IDON復(fù)發(fā)在統(tǒng)計學(xué)上無關(guān),單雙眼(P=0.001)和最后轉(zhuǎn)歸(P0.001)與IDON復(fù)發(fā)有關(guān)。將上述P0.2的指標經(jīng)多因素分析顯示,IDON的復(fù)發(fā)與最后轉(zhuǎn)歸、單雙眼、激素劑量有關(guān),其中IDON的患者轉(zhuǎn)歸為脫髓鞘改變的復(fù)發(fā)率是40.74%,多發(fā)性硬化(MS)為70.00%,視神經(jīng)脊髓炎(NMO)為88.89%,均明顯高于不明原因組8.70%(P≤0.001),單眼ON復(fù)發(fā)率高達40.00%,明顯高于雙眼ON復(fù)發(fā)率12.00%(P=0.009),治療激素劑量為基因效應(yīng)組的復(fù)發(fā)率是42.11%,而非基因效應(yīng)組為25.00%(P=0.045)。 結(jié)論：最后轉(zhuǎn)歸、單雙眼和激素劑量是影響IDON復(fù)發(fā)的重要因素。復(fù)發(fā)視神經(jīng)炎(ON)可作為轉(zhuǎn)歸為MS和NMO的強烈預(yù)測因子,應(yīng)對此類病患做好疾病的科普宣教,重視定期復(fù)查及隨訪。同時進一步證實了單眼ON與雙眼ON存在差異,應(yīng)對兩者分開研究。
[Abstract]:Objective: to analyze the possible factors causing the recurrence of idiopathic demyelinating optic neuritis (IDON) and to provide evidence for the prevention of recurrence. Methods: the data of the inpatients with idiopathic demyelinating optic neuritis from January 2003 to January 2011 in the first affiliated Hospital of Guangxi Medical University were collected by retrospective study. It was followed up to find out the factors related to recurrence and the deadline of observation was January 2012. The possible causes of recurrence were analyzed by univariate and multi-factor analysis. Results: a total of 115 patients with idiopathic demyelinating neuritis were enrolled in this study. 32 cases of recurrence and 83 cases of non-recurrence were found at follow-up. The results of univariate analysis showed that age was 0.453). The first best corrected visual acuity (BCVA) of the affected eyes was 0.962D, gender was 0.091g, eye pain was 0.398g, edema of optic disc was 0.098). There was no statistically significant correlation between the hormone dose of 0.128 and whether or not demyelinating P0. 082 at the beginning of onset of IDON recurrence. P0. 001) and P0. 001) were associated with the recurrence of IDON. The multivariate analysis showed the recurrence and final outcome of P0. 2. The recurrence rate of IDON was 40.74 and that of multiple sclerosis was 70.00%. The NMO of optic neuromyelitis was 88.89, which was significantly higher than that of unexplained group (P 鈮，

本文編號：1455528