摘要
目的 探讨视神经炎与多发性硬化 ( MS)视神经功能改变的特点。方法 采用 x2 检验与 t检验对患者视神经功能改变的特点进行分析。结果 ( 1 )视神经炎视力障碍严重 ,82 %视力低于 0 .1 ;MS视功能障碍常见 ,其中尤以 MS视神经脊髓炎型严重 ,81 %视力低于 0 .1 ,77%双眼视力低于 0 .1。 ( 2 )视神经炎、MS的 VEP异常率高达 80 %～ 88% ,MS视神经脊髓炎型 VEP异常率高达 95 % ,主要表现为潜伏期延长。( 3)视神经炎鞘内 Ig G合成率低于 MS。 ( 4)两组部分患者经过大剂量肾上腺糖皮质激素治疗后 ,视力恢复到 0 .5以上者约 31 %～ 33%。结论 视神经炎是 MS的最常见症状之一 ,视神经炎与 MS视神经脊髓炎型的视神经损害发生频率高且程度重 ,迫切需要对急性视神经炎患者进行早期诊断并及时给予大剂量肾上腺糖皮质激素治疗。
Objective To study the visual functional disorders of optic neuritis and multiple sclerosis (MS).Methods Visual acuity,funduscopy,CT and/or MRI were assessed in cases of optic neuritis and MS patients.CSF IgG determinations and oligoclonal bands were assessed in part of them,by x 2 and t test. Results(1) 82% patients with optic neuritis had visual acuity less than 0 1 (P<0 05,compared with MS). Abnormal visual function test results were commonly observed in patients with MS. 81% patients with optic neuromyelitis phenotype of MS had visual acuity less than 0 1,77% of them had visual acuity less than 0 1 in two eyes (compared with non optic neuromyelitis of MS:P<0 005).(2) VEP showed the abnormalities in 80%～88% of optic neuritis and MS,in 95% optic neuromyelitis of MS,with the feature of prolonged potential time.(3)CSF oligoclonal bands were comparable,but CSF IgG synthesis rates in patients with optic neuritis were less than that in MS (P<0 01). (4) The rates of visual acuity over 0.5 after high dose of corticosteroid in part of optic neuritis and MS were about 31%～33%.Conclusions Optic neuritis was a common feature of MS.The visual disorders in patients with optic neuritis and optic neuromyelitis phenotype of MS were common and serious.There were abnormal immunological responses in optic neuritis as well as in MS.So,the early diagnosis and treatment of high dose of corticosteroid for acute optic neuritis is necessary and imperative.
出处
《中国神经免疫学和神经病学杂志》
CAS
2001年第4期211-214,共4页
Chinese Journal of Neuroimmunology and Neurology
