Multiple sclerosis - Severity and progression rate in African Americans compared with whites
Multiple sclerosis - Severity and progression rate in African Americans compared with whites
复制标题
DOI：
10.1097/01.phm.0000078199.99484.e2
复制
发表时间：
2003-08-01
影响因子：
3
通讯作者：
Norton, HJ
中科院分区：
文献类型：
--
作者：
Kaufman, MD;Johnson, SK;Norton, HJ
目的：虽然流行病学表明多发性硬化症在白人中比非洲裔美国人更常见，但疾病的过程在非洲裔美国人中可能更具侵略性。本研究探讨疾病过程中的一个大型多发性硬化症clinic population.Design：病例对照，回顾性记录审查比较了多发性硬化症的严重程度为非洲裔美国人和白人。由于两组的基线人口统计学不同，我们进行了多个亚组的分析，试图控制各种characteristics.Results：一致的证据表明，更多的残疾在非洲裔美国人相比，白人被发现，虽然亚组往往太小，建立统计学意义。非裔美国人的平均扩展残疾状况量表得分高于白人在一个亚组中选择，以尽量减少在获得护理和疾病的看法差异。非裔美国人报告肢体无力作为多发性硬化症的表现症状比白人更频繁。当患者在我们的多发性硬化症中心，疾病进展的速度几乎是相同的。结论：更多的非洲裔美国人比白人的经验，锥体系统参与多发性硬化症的早期，导致更大的残疾作为衡量的门诊敏感的扩展残疾状态量表。一旦患者有中度行走困难，两组的进展速度是相同的，尽管白人发生的年龄比非洲裔美国人晚。
Objective: Although epidemiology indicates that multiple sclerosis is more common among whites than African Americans, the course of disease may be more aggressive among African Americans. This study examines disease course in a large multiple sclerosis clinic population.Design: A case-controlled, retrospective record review compared the severity of multiple sclerosis for African Americans and for whites. Because the baseline demographics of the two groups differed, we performed analyses of multiple subgroups in an attempt to control for various characteristics.Results: Consistent evidence of more disability in African Americans compared with whites was found, although subgroups were often too small to establish statistical significance. African Americans had a higher mean Expanded Disability Status Scale score than whites in a subgroup selected to minimize differences in access to care and disease perceptions. African Americans reported limb weakness as a presenting symptom of multiple sclerosis more frequently than did whites. When patients were followed at our multiple sclerosis center, rates of disease progression were nearly identical.Conclusions: More African Americans than whites experience pyramidal system involvement early in multiple sclerosis, leading to greater disability as measured by the ambulation-sensitive Expanded Disability Status Scale. Once patients have moderate difficulty walking, the rate of progression is the same for both groups, albeit occurring at a later age for whites than for African Americans.