The Clinical Characteristics Of 105 Patients With Multiple Sclerosis And Treatment Analysis

ObjectivesMultiple sclerosis(MS) is a kind of autoimmune disorder which refer to the demyelination of central nervous system. To further understand its clinical characters and improve the diagnostic and treatment level, we comprehensively analyzed the following clinical symptom characteristics which including the age of onset, forms of onset, trigger factors, first symptoms, auxiliary examination and clinical treatment effect.MethodsAll the total 105 MS cases which meet the diagnostic criteria of Poser were enrolled in this study, among them 59 cases were from the 2nd affiliated hospital of Zhengzhou university between 2005.1-2010.10, and the other 46 cases were from the 1st affiliated hospital of Zhengzhou university between 2008.1-2010.10. Retrospective analysis method was used for the further process.ResultsAll the total 105 MS cases which meet the diagnostic criteria of Poser were enrolled in this study, the result shown that among all the MS cases in this study,58 (55.2%)cases were female, and 47 (44.8%) were male, the ratio between them was 1.17:1; age of onset were between 4 and 69 years, and the average age were 36.5 years old, and its peak was 20 to 40 years old; 29.5% of the MS patient had at least one trigger factors mainly infection or overworked; most onset form of MS were subacute (61.0%) or acute (27.6%), but few chronic onset; respectively the subtypes of the MS were the Support clinical confirmed cases 41.0%, Laboratory confirmed cases 18.1%, possible clinical confirmed cases 37.1%; Among all the cases, the radio of the relapsing-remitting type was 81.9%, secondary progressive type was 14.3%; the proportion of first symptoms were following motor weakness 36.2%, paresthesias 22.9%, and decrease of vision 11.4%, dizziness of 9.5%. the most common symptoms and signs of nervous system was paresthesias 80.1%, and superficial sensation disorder occupied 83.8% mainly pain or temperature; optic nerve was easier to be involved than other cranial nerves so the symptoms of ophthalmopathy were priority to others, and the optic nerve damage take a percentage of 54.2%, slightly higher than domestic reports of 50.4%. Cerebrospinal fluid oligonucleotide positive or cloning zones 32.3%, IgG quantitative abnormal protein of 34.2%. In this study, the percentage of patients who took head magnetic resonance imaging (MRI) inspection is 92.3%, and 90.1% were abnormal, meanwhile the abnormal rate of Spinal cord MRI is 83.7%, most of these lesions were within the white matter of brain especially around the Ventricles.35.2% of the cases took the examinations of visual evoked potential (VEP), brainstem auditory evoked potential (BAEP) or somatoform evoked potential (SEP). All of the applications of dexamethasone, methyl-prednisone or immunoglobulin, were proved to useful for MS. they could not only delay its progress but also reduce the incidence of recurrence. But both dexamethasone and methyl-prednisone had certain side effects, and some of them can be avoid by some prevention methods.ConclusionMajority of MS patients are young or middle-aged, and many of them are women, the forms of onset most are acute or subacute, some patients have definite trigger factors, weakness is the most common symptoms, Secondly are paresthesias and ophthalmopathy. In the cranial nerve damage, optic nerve is most easily be involved, brain white matter area around ventricles are the more common to be involved than basal ganglia, while the cerebellum is rare. Cerebrospinal fluid examination can improve the diagnosis of MS. MRI it has higher sensitivity to found MS lesions than that CT; it is easer to find the sub-clinical lesions. Application of adrenal glucocorticoid has better clinical effect, and it can relieve the symptoms, delay the progress of the disease even with some side effects. And all globulin treatment for MS with the similar function of glucocorticoid can be determined. Glucocorticoid therapy group were better than the other groups, but the there no obvious difference between glucocorticoid (dexamethasone, methyl-prednisone) treatment, globulin treatment and immunosuppressive treatment.