Clinical Study Of The Spectrum Of Neuromylitis Optica And Multiple Sclerosis

Objectives:Analyzed the clinical characteristics of the spectrum of neuromyelitis optica and multiple sclerosis, analyzed the progress of disability status and impact of prognostic factors of the NMO and MS patients, to further the understanding of such diseases.Methods:Collected the clinical data and serum, input all data in the pre-built Access database; Tested AQP-4antibodies in the serum by the Cell based fluorescent immunostaining assay; Analyzed the clinical characteristics of patients in each group, the progress of disability of NMO and MS patients, and also the prognostic factors of NMO and MS patients.Results:1. NMO, the limited forms of NMO and MS have some incentive before the onset, infection and fever are the most popular prodromic symptoms. NMO, as well as the limited forms of NMO were common in middle-aged female patients, often accompanied by autoimmune diseases, the spinal cord MRI reveals transverse and injury, the lesion extends contiguously over3or more vertebral segments, the brain MRI scans can be abnormal during the course.2. AQP-4antibodies in LETM patients with the highest rate of83.33%, followed by NMO (79.17%), ON (78.57%), MS was negative. The positive rate of AQP-4antibody between NMO spectrum diseases groups and MS group was significant difference (P<0.05), but there was no difference between NMO and its spectrum diseases in each group (P>0.05).3. The EDSS score and the number of involved spinal segments was relevance in NMO patients, r=0.446, P=0.000, there was significant difference, and it had no significant correlation in MS patients, r=0.019,P=0.917.4. Kaplan-Meier curve of MS patients was higher than that of NMO, the Log-Rank test, P=0.037<0.05, there was significant differences in disability status progress between two groups.5. The number of spinal segments involved, with or without sphincter dysfunction, AQP-4antibody results were the main prognostic risk factors of NMO. Sphincter dysfunction and the brain lesions were the prognostic risk factors of MS.Conclusions:1. NMO, the limited forms of NMO and MS had some incentive before the onset, infection and fever are the most popular prodromic symptoms, suggesting that infection or inflammation events can trigger an immune-mediated mechanism, and involved the pathological mechanisms of disease.2. Most NMO and the limited forms of NMO were common in middle-aged female patients, obvious feminization of patients, often accompanied by autoimmune diseases, the spinal cord reveals transverse injury, the lesion extends contiguously over3or more vertebral segments, the EDSS score and the number of involved spinal segments was relevance, suggesting that the clinical symptoms and imaging features are interdependent, the brain MRI scans can be abnormal during the course.3. AQP-4antibody is a specific biological indicator of NMO.4. The progression of disability in NMO patients was faster than that of MS.5. Spinal cord involvement in the longer segment, there sphincter function impairment and AQP-4antibody-positive, suggest poor prognosis in NMO; Sphincter dysfunction and brain lesions suggested poor prognosis in MS.