广西多发性硬化254例患者的临床特点.doc

广西多发性硬化254例患者的临床特点( 张先龙 唐玉兰 肖凯文 摘要 目的 归纳总结中国广西地区多发性硬化(MS)患者的临床特征.方法 从临床资料、辅助检查等方面对 254例多发性硬化患者进行回顾性分析.结果 MS好发于青年女性, 201（79.13%）病例呈急性或亚急性起病; 87(34.25%)病例病前有诱发因素;首发症状以肢体无力、感觉障碍和视力减退最常见;临床表现以肢体无力、感觉障碍、脑神经受损较为突出;发作性症状多见119例(46.85%);周围神经损害24例(9.4%);联合运用MRI 和诱发电位检查能发现亚临床病灶，可提高早期诊断率。结论 MS的临床表现具有多样性和复杂性，临床应加强对其认识。颅脑MR I及诱发电位具有很高的诊断价值。 关键词 多发性硬化；临床特点 Clinical features of 254 patients with multiple sclerosis in guangxi ZHANG Xian-long, Department of Neurology, Central Hospital of Loudi , Hunan, Loudi 417000,China;TANG Yu-lan, XIAO Kai-wen, Department of Neurology, First Affiliated Hospital, Guangxi Medical University, Nanning 530021, China Abstract: Objective To summarize the clinical features of patients with multiple sclerosis(MS) in guangxi. Methods 254 multiple sclerosis patients were analyzed retrospectively From the clinical data and auxiliary examination. Results　MS mainly invades young women, Among 254 cases, 79.13% was found mostly acute or subacute in onset. Before onset, 34.25% cases had causative factors. Limb weakness, paresthesia and visual disturbance were the most common initial symptoms.Clinical manifestations of limb weakness, sensory disturbances, cranial nerve impairment is more prominent, episodic symptoms were more common (46.85%), some have peripheral nerve damage (9.4%), Combined use of evoked potentials and MRI findings may be helpful for discovering subclinical lesions in CNS, which can improve early diagnosis. Conclusion There are diverse and complex clinical manifestations in patients with MS. We should deepen the recognition to MS. brain MRI and evoked potential have important significance. Key words: multiple sclerosis; Clinical characteristic 多发性硬化(Multiple sclerosis, MS)是中枢神经系统脱髓鞘疾病，临床上的两个主要特征是发病时间和空间上的播散性，MS是具有一种迁延的，不规则的，有时每况愈下的病程，但倾向于阵发性地复发和缓解，脑和脊髓内存在着多灶脱髓鞘斑，临床表现常为分布广泛的神经系统功能缺失。病因不详，有地域性、遗传性，可能是遗传易患个体与环境因素相互作用的结果。本研究针对1993年至2008年在广西医科大学第一附院住院的254例确诊为MS患者。采用Poser 等和McDonald诊断标准进行诊断。归纳总结中国广西MS发病规律、临床表现、诱发电位、核磁共振及CT。 1.临床资料 1.1一般资料：共254例,