A prospective study on the prognosis of multiple sclerosis
A prospective study on the prognosis of multiple sclerosis
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DOI：
10.1007/s100720070021
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发表时间：
2000-01-01
影响因子：
3.3
通讯作者：
Ponziani, G.
中科院分区：
文献类型：
--
作者：
Amato, M. P.;Ponziani, G.
对224例首次诊断为多发性硬化（MS）的患者进行了前瞻性随访，平均随访时间为9.78年。我们将达到不可逆残疾水平（对应于EDSS评分4.0和6.0）的时间以及复发缓解患者亚组中继发进展期的开始作为终点。最初进展的过程和较高的基础EDSS评分被证明是预后不良的最佳预测因子。发病时涉及的功能系统数量较多，以及锥体、视觉、括约肌和小脑系统的残留缺陷较多，是预测预后不良的其他因素，而感觉系统的参与被证明是有利的。较长的首次发作间隔与较好的预后相关。然而，在疾病的头两年复发的总数是没有预后价值的。脑脊液中寡克隆带的存在和在疾病早期阶段强烈提示或提示MS的脑MRI检查与更差结局的可能性较高相关。
Two hundred and twenty-four patients at their first diagnosis of multiple sclerosis (MS) were prospectively followed for a mean period of 9.78 years. We considered as endpoints the time to reach non-reversible disability levels corresponding to EDSS scores of 4.0 and 6.0, and the beginning of a secondary progressive phase in the relapsing-remitting subgroup of patients. An initially progressive course and higher basal EDSS scores proved to be the best predictors of unfavorable prognosis. A greater number of functional systems involved at onset as well as higher residual deficits in pyramidal, visual, sphincteric and cerebellar systems were other factors predictive of a poor outcome, whereas sensory system involvement turned out to be favorable. A longer first inter-attack interval was associated with a better prognosis. However, overall number of relapses in the first two years of the disease was of no prognostic value. The presence of oligoclonal banding in the cerebrospinal fluid and a cerebral MRI exam strongly suggestive or suggestive of MS in the early phases of the disease were associated with a higher probability of a worse outcome.