本文選題：急性視神經(jīng)炎　切入點(diǎn)：復(fù)發(fā)　出處：《廣西醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：一、目的:約有30%的急性視神經(jīng)炎患者在5年內(nèi)會(huì)經(jīng)歷至少一次的復(fù)發(fā)。目前尚缺乏種族和視神經(jīng)炎復(fù)發(fā)是否有關(guān)的研究。另外,由于缺乏針對(duì)視神經(jīng)炎復(fù)發(fā)危險(xiǎn)因素的前瞻性研究,我們?nèi)圆淮_定除了糖皮質(zhì)激素的劑量,是否還存在其他影響急性視經(jīng)炎復(fù)發(fā)的危險(xiǎn)因素。本研究旨在通過(guò)對(duì)既往ONTT數(shù)據(jù)進(jìn)行cox回歸分析,來(lái)探究急性視神經(jīng)炎復(fù)發(fā)的危險(xiǎn)因素。二、方法:根據(jù)既往北美視神經(jīng)炎治療試驗(yàn)(optic neuritis treatment trail,ONTT)(前瞻性隨機(jī)對(duì)照試驗(yàn),RCT)的原始研究數(shù)據(jù),將患者按照復(fù)發(fā)、未復(fù)發(fā)重新分組。提取每位已納入且未失訪患者的信息后,使用spss23.0對(duì)所得數(shù)據(jù)進(jìn)行Kaplan-Meier檢驗(yàn)的初篩后,使用cox回歸分析并得出結(jié)論。提取患者生存時(shí)間、狀態(tài)、治療組和年齡、性別、種族、視力等自變量。三、結(jié)果:Kaplan-Meier分析提示年齡(p=0.012)和治療組(p=0.015)與急性視神經(jīng)炎的復(fù)發(fā)有關(guān)。而性別、種族、MRI結(jié)果、對(duì)比敏感度、視力(logMARETDRS)、視盤水腫、眼底出血、黃斑滲出、眼痛、確診多發(fā)性硬化、多發(fā)性硬化家族史、神經(jīng)癥狀病史、過(guò)去30年病毒感染史、以北緯40°生活了15年和發(fā)病季節(jié)和急性視神經(jīng)炎的復(fù)發(fā)無(wú)關(guān)。COX回歸分析發(fā)現(xiàn)發(fā)病年齡=30歲(HR:1.570,95%CI:1.133-2.175,p=0.007)和單純口服潑尼松(1 mg/kg/day)(HR:1.694,95%CI:1.145-2.507,p=0.008)是視神經(jīng)炎復(fù)發(fā)的獨(dú)立危險(xiǎn)因素。四、結(jié)論:年齡小于等于30歲和口服潑尼松(1mg/kg/day)是急性視神經(jīng)炎復(fù)發(fā)的危險(xiǎn)因素。建議臨床工作者在治療急性視神經(jīng)炎時(shí)不單純使用潑尼松,并對(duì)發(fā)病年齡小于等于30歲的患者進(jìn)行積極的隨訪,及早進(jìn)行干預(yù),降低特發(fā)性視神經(jīng)炎的復(fù)發(fā)風(fēng)險(xiǎn),以改善預(yù)后。
[Abstract]:Objective: about 30% patients with acute optic neuritis will experience at least one relapse within 5 years. In the absence of a prospective study of the risk factors for recurrence of optic neuritis, we are still uncertain about the dose of glucocorticoids, Whether there are other risk factors affecting the recurrence of acute optic neuritis. This study was designed to explore the risk factors for the recurrence of acute optic neuritis by using cox regression analysis of past ONTT data. Methods: according to the original study data of Optic neuritis treatment ONTT (prospective randomized controlled trial), the patients were reclassified according to recurrence and no recurrence. After using spss23.0 to screen the obtained data for Kaplan-Meier test, cox regression analysis was used to draw the conclusion. Independent variables such as survival time, state, treatment group and age, sex, race, vision were extracted. Results the age of p0.012) and the treatment group p0.015) were associated with the recurrence of acute optic neuritis. Sex, race, MRI findings, contrast sensitivity, visual acuity, optic disk edema, fundus hemorrhage, macular exudation, eye pain, multiple sclerosis, A family history of multiple sclerosis, a history of neurological symptoms, a history of viral infection in the past 30 years, After 15 years of living at 40 擄N and no correlation between the onset season and the recurrence of acute optic neuritis. Cox regression analysis found that HR1: 1.570,95CI1: 1.133-2.175% (CI: 1.133-2.175) and prednisone (1.69495 CIW 1.145-2.507p0.008) were independent risk factors for the recurrence of optic neuritis. Conclusion: age less than 30 years and oral prednisone 1 mg / kg / day are risk factors for recurrence of acute optic neuritis. It is recommended that clinical workers should not use prednisone alone in the treatment of acute optic neuritis. In order to improve prognosis, early intervention was carried out to reduce the risk of recurrence of idiopathic optic neuritis.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R774.61

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