Clinical Classification And Prognosis Of Patients With Multiple Sclerosis In Northern China

Background and Objectives: Multiple sclerosis (MS) is a common chronic immune-mediatedcentral nervous system disease, with white matter demyelination as the characteristics of themain pathological changes. As MS can make the brain and spinal cord nerve tissue extensivemyelin breakdown, as well as some axonal fracture, astrocyte proliferation, necrosis, scarformation, gray matter injury, peripheral neuropathy and so on, the patients can not be fullycompensatory rehabilitation, with the neurological dysfunction gradually increased, a gradualdecline there is in the quality of life, and lead to higher disability rate. About20-25million patientsare subjected to prolonged the torture of MS around the world, and is places a significant burdento society. At home and abroad, there are a lot of basic work on MS, but the applied aspects ofMS onset with significant geographical differences in characteristics. And the natural history ofMS patients classification and lesion space classification are still very scarce in northern China.By means of MRI imaging, this study observed the degree of neurological deficits in patientswith different types and quality of life impact in different types of lesion location classificationand natural history of MS. Try to explore the general incidence of the patients in north withdisease characteristics, features and prognosis of the different clinical subtypes, and also thelesion time spatial trends between MS outcome. Ultimately, the clinicians of the Department ofNeurology could improve the diagnostic level for northern MS patients with disease outcome,and improve the relevance of clinical drug treatment with understanding the possiblemechanisms of MS deeply.Material and Methods: We summarized the132cases of MS in the Jilin University BethuneClinical Hospital from January2009to December2011,which have perfect head and spinal cordMRI images. By studying the lesion location and the natural history of the synchronous type and the EDSS and MSQOL-54score，we analyed the differences and the relevant trend. For the data,we applied SPSS19.0package for processing, using the t test, multiple testing of single factoranalysis of variance, Tamhane’s T2test for, the variance which; frequency distributionapplication X2test, the linear trend test. P <0.05was considered statistically significant.Results:1. there are132cases of northern patients in this study and the average age of them is38.33,female: male=2.57:1; RRMS is common in the types of natural history, accounting for84cases (63.6%); the brain spinal cord hybrid is common in the types of lesion location,accounting for60cases (45.5%). Between the various clinical classification of gender-relatedanalysis of the classification of clinical subtypes, there were no significant gender bias (P>0.05).2. The characteristic of intracranial lesion distribution is that many lesions lying in semi-ovalcenter and next to the lateral ventricle, with75cases (72.1%) and62cases (59.6%, respectively)in this study. Spinal cord lesions predilection for cervical spinal cord, accounting for62cases(70.5%), followed by the thoracic spinal cord of50cases (56.8%), and at least the lumbar spinalcord is3cases (3.4%).3. types of lesion and prognostic analysis: Overall each lesion sub-type,the EDSS and MSQOL-54score are significant differences (P <0.01), between simple braindamage to the MS, mixed damage of the brain spinal cord to the MS and simple spinal corddamage; in the lesion location types within natural history types, the score of RRMS is the sameto the overall result; in the SPMS type, spinal cord nerve dysfunction is more serious than thesimple brain type, while the hybrid type has non-significant difference compared to the previoustwo. The MSQOL-54score is no significant difference between the three before (P>005).4, thetypes of natural history and prognosis: overall natural history of sub-type, the EDSS andMSQOL-54score of progressive MS (with SPMS, PPMS, PRMS is more serious than RRMS (P<0.05). In the three types of progressive MS, the neurological dysfunction and quality of lifeimpact of the difference was not significant between each other (P>0.05). The score of eachlesion location type with parting internal natural history is similar to the overall.5. MS patientswith lesions of the trends in the relationship of time and space (χ2linear is17.334, P <0.01).Conclusions：The number of the females is lager than the males in MS, average age is about38years old; The intracranial lesion distribution is predilection for semi-oval center and plase nextto the lateral ventricle. Spinal cord lesions predilection for cervical spinal cord. In the types ofnatural history, RRMS is common. The type of brain spinal cord hybrid is the main type of lesion location. With the type of RRMS, neurological deficits and quality of life are better thanother types; all types of progressive MS (with SPMS, PPMS, PRMS) are significantly worse,with no significant difference between each other in it. Simple brain damage type patients havebetter quality of life and less neurological dysfunction, the followed is brain spinal cord hybridtpye, and pure spinal cord type is the most serious. Among all the types, time and space have nosignificant gender trend. A linear trend associated lesion classification and natural history ofclinical classification. Purely cerebral lesions tend to RRMS, and spinal cord tends toprogressive.