Correlation Analysis Of Clinical Features Between Neuromyelitis Optica Spectrum Disease And Multiple Sclerosis

Objective:Neuroomyelitis optica spectrum disease(NMOSD)and multiple sclerosis(MSTo explore the differences in general clinical characteristics and laboratory examinations between patients with and without SADs of NMOSD combined with systemic autoimmune diseases(SADs),so as to facilitate better diagnosis and treatment.Methods:Patients admitted to our hospital from 2013 to 2018 were selected as subjects in this study.According to the 2015 international Panel for NMO Diagnosis(IPND),the new diagnostic criteria for NMOSD and the 2017 McDonald MS diagnostic criteria,the patients were divided into NMOSD group and MS group.The general clinical data,laboratory examination and laboratory characteristics of imaging data of patients were compared,and the differences between the clinical characteristics of NMOSD and MS patients and the general clinical characteristics of patients with SADs in NMOSD patients were studied by statistical methods.Results:1.The male/female ratio of NMOSD and MS was 2/29 and 17/26,respectively,and the difference between the two groups was statistically significant(=10.331,P=0.01).The mean age of onset of NMOSD was 42.33 10.39 years,and the mean age of onset of MS was 30.74 7.06 years.The age of onset of NMOSD was later than that of MS,and the difference between the two groups was statistically significant(=5.716,P=0.000).There was no significant difference between the two groups(P>0.05).Bladder and rectum in 8 cases(25.8%),dysphagia in 5 cases(16.1%),which was higher than that in 16 cases(37.2%),bladder and rectum in 2 cases(4.7%),and dysphagia in 0 cases(P<0.05).For patients with the first symptom of limb weakness,the clinical manifestations of NMOSD were paraplegia in 16 cases(66.7%),tetraplegia in 4 cases(16.7%),hemiplegia in 1 case(4.2%),and monoplegia in 3 cases(12.5%).There were 8 cases of paraplegia(30.8%),11 cases of monoplegia(42.3%),4 cases of hemiplegia(15.4%)and 3 cases of tetraplegia(11.5%)in MS.The incidence of paraplegia in NMOSD was higher than that in MS,and the difference between the two groups was statistically significant(=6.443,P=0.011).The number of patients with MS was significantly higher than that of NMOSD,and the difference between the two groups was statistically significant(=5.500,P=0.019).Among the patients with the first symptom of sensory disturbance,11 cases(73.3%)had paresthesia in NMOSD and 17 cases(77.3%)in MS.There were 12 NMOSD(80%)and 13 MSS(59.1%).The results showed that there was no statistical difference between the two groups(P>0.05).In the NMOSD group,there were 9 cases(60%)of deep sensory disturbance,higher than the 6 cases(27.3%)of MS.The difference between the two groups was statistically significant(=3.963,P=0.047).In the laboratory examination of NMOSD cerebrospinal fluid,12 patients(38.7%)had elevated WBC,which was higher than that of 7 patients(16.3%)with MS,and the difference was statistically significant(=4.749,P=0.029).In MS group,there were 21 cases(48.8%)and 28 cases(65.1%)with positive Oligo clonala bands(OCB),which were higher than 2 cases(6.5%)and 1 case(3.2%)of NMOSD(P<0.05).The changes of cerebrospinal fluid pressure and protein concentration showed no statistical significance(P>0.05).There were 26(83.9)positive antinuclear antibody series in the NMOSD group,13(41.9%)positive thyroid related antibody series,and 29(93.5%)positive AQP4 antibody series in the NMOSD group,all higher than that in the MS group.The difference between the two groups was statistically significant(P<0.05).Magnetic resonance imaging,NMOSD group of patients with lesions of the spinal cord has 24 cases(77.4%),occurred long segmental spinal cord lesions(longitudinally extensive cord lesions,LDSCLs)of 22 cases(71.0%),higher than that of MS 23 cases(53.5%)and 4 cases(9.3%),the difference has statistical significance(P<0.05).The incidence of intracranial lesions of MS was higher than that of NMOSD,and the difference between the two groups was statistically significant(=4.841,P=0.028).2.Among the first clinical manifestations of nmosd-sads group and nmosd-non-sads group,there were 6 cases(75%)of ON in the nmosd-sads group,which was higher than that in the nmosd-non-sads group(26.1%).The difference between the two groups was statistically significant(=4.101,P＝0.043).In the NMOSD group,there was 1 case(12.5%)of bulbar last area syndrome,while in the NMOSD-non-sads group,there was no significant difference between the two groups(=5.625,P=0.018).The rest showed no obvious difference(P>0.05).The positive rates of thyroid ball antibody,anti-nuclear antibody,anti-ssa and anti-ssb in the nmosd-sads group were significantly higher than those in the nmosd-sads group(P<0.05).Conclusions:NMOSD and MS are two completely independent diseases.Although there are some similarities,there are differences in epidemiology,clinical characteristics,laboratory and imaging.Early identification should be paid attention to in clinical practice.Patients with NMOSD combined with SADs are more likely to start with ON as the first symptom,and the positive rate of serum autoantibodies is higher than that of patients without SADs.Therefore,more attention should be paid to whether there are SADs in the combination of NMOSD with ON and NMOSD with positive autoantibodies.