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Different clinical characteristics of longitudinally extensive transverse myelitis with and without connective tissue disorders: a single-center retrospective study.
Neurological Sciences ( IF 3.3 ) Pub Date : 2020-04-23 , DOI: 10.1007/s10072-020-04429-y
Qiu-Xia Zhang 1 , Chen-Na Huang 1 , Lin-Jie Zhang 1 , Ming Yi 1 , Nan Wang 1 , Shu-Min Jiang 1 , Li-Sha Chou 1 , Sheng-Hui Chang 1 , Ting Li 1 , Li Yang 1
Affiliation  

BACKGROUND AND OBJECTIVE Autoimmune longitudinal extensive transverse myelitis (LETM) is often combined with connective tissue disorders (CTD). The purpose of this study was to compare the clinical characteristics of autoimmune LETM with and without CTD. METHODS Ninety-two patients diagnosed with autoimmune LETM were enrolled from our clinical database and divided into two groups depending on whether they had a concomitant diagnosis of CTD. Differences in clinical, serological, and imaging characteristics between the two groups were evaluated and compared. RESULTS Fifty-nine LETM patients without CTD and 33 LETM patients with CTD were included. LETM patients with CTD had higher Kurtzke Expanded Disability Status Scale at nadir and more severe sensory dysfunction (p < 0.05) than those without CTD. It was also found that LETM patients with CTD, compared with those without CTD, had elevated levels of immune inflammation markers such as IgG, IgA, and globulins (p < 0.05). These abovementioned characteristics were more prominent in patients with aquaporin-4 antibodies (AQP4-ab) than in those without them. In addition, the most common type of CTD in LETM was Sjögren syndrome (SS), which was usually diagnosed at the time of LETM or later. CONCLUSION LETM patients with CTD, especially those with AQP4-ab, had greater sensory dysfunction and higher levels of inflammatory markers than did LETM patients without CTD. Multicenter cooperation and long-term follow-up are necessary to further study the inherent implications and prognosis of the disease.

中文翻译:

具有和不具有结缔组织疾病的纵向广泛性横贯性脊髓炎的不同临床特征:单中心回顾性研究。

背景和目的自身免疫性纵向广泛性横贯性脊髓炎(LETM)通常合并结缔组织疾病(CTD)。这项研究的目的是比较具有和不具有CTD的自身免疫性LETM的临床特征。方法从我们的临床数据库中收集了92例被诊断为自身免疫性LETM的患者,根据他们是否伴有CTD诊断而分为两组。评估和比较两组之间在临床,血清学和影像学特征上的差异。结果包括59例无CTD的LETM患者和33例有CTD的LETM患者。与没有CTD的患者相比,患有CTD的LETM患者在最低点时具有较高的Kurtzke扩展残疾状态量表,并且感觉功能障碍更为严重(p <0.05)。还发现LETM患者患有CTD,与没有CTD的患者相比,IgG,IgA和球蛋白等免疫炎症标记物水平升高(p <0.05)。具有水通道蛋白4抗体(AQP4-ab)的患者的这些上述特征比没有其的患者更为突出。此外,在LETM中最常见的CTD类型是Sjögren综合征(SS),通常在LETM或更晚时期就被诊断出。结论与没有CTD的LETM患者相比,患有CTD的LETM患者,特别是那些患有AQP4-ab的患者,感觉功能障碍和炎症标志物水平更高。为了进一步研究该疾病的内在影响和预后,必须进行多中心合作和长期随访。具有水通道蛋白4抗体(AQP4-ab)的患者的这些上述特征比没有其的患者更为突出。此外,在LETM中最常见的CTD类型是Sjögren综合征(SS),通常在LETM或更晚时期就被诊断出。结论与没有CTD的LETM患者相比,患有CTD的LETM患者,特别是那些患有AQP4-ab的患者,感觉功能障碍和炎症标志物水平更高。为了进一步研究该疾病的内在影响和预后,必须进行多中心合作和长期随访。具有水通道蛋白4抗体(AQP4-ab)的患者的这些上述特征比没有其的患者更为突出。此外,在LETM中最常见的CTD类型是Sjögren综合征(SS),通常在LETM或更晚时期就被诊断出。结论与没有CTD的LETM患者相比,患有CTD的LETM患者,尤其是那些患有AQP4-ab的患者,感觉功能障碍和炎症标志物水平更高。为了进一步研究该疾病的内在影响和预后,必须进行多中心合作和长期随访。结论与没有CTD的LETM患者相比,患有CTD的LETM患者,特别是那些患有AQP4-ab的患者,感觉功能障碍和炎症标志物水平更高。为了进一步研究该疾病的内在影响和预后,必须进行多中心合作和长期随访。结论与没有CTD的LETM患者相比,患有CTD的LETM患者,尤其是那些患有AQP4-ab的患者,感觉功能障碍和炎症标志物水平更高。为了进一步研究该疾病的内在影响和预后,必须进行多中心合作和长期随访。
更新日期:2020-04-24
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