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在第一次脱血事件后,与年龄相关的残疾结果

Alvaro Cobo-Calvo¹, Pere Carbonell-Mirabent¹, Carmen Tur¹

¹Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain.

|February 4, 2025

概括

患有多发性硬化症 (MS) 第一次脱髓化事件的老年人 (40-50岁) 炎症较少,但神经退行风险较高. 这突显了年龄是MS进展和残疾的关键因素.

科学领域:

神经学神经学
神经免疫学神经免疫学
临床研究临床研究

背景情况:

多发性硬化症 (MS) 的残疾累积可以在早期开始.
老龄化是MS进展和残疾的一个重要因素.
早期发现MS进展对于管理至关重要.

研究的目的:

调查第一个脱髓化事件 (FDE) 时的年龄对MS进展的预后影响.
分析不同年龄组的各种残疾结果.
评估炎症和神经退行性标志物的特定年龄差异.

主要方法:

自1994年以来,对1170名年龄在18-50岁的患者进行了前性队列研究.
分类为三个年龄组:18-29岁,30-39岁和40-50岁.
对复发相关恶化,复发率,EDSS轨迹和多个结局的Cox回归分析进行比较,包括PIRA和CDA.

主要成果:

40-50岁的年龄组在FDE中出现了更高的复发相关恶化和更大的年度EDSS增加.
这一老年人群的炎症结局 (复发,新病变) 风险较低,但确认残疾累积 (CDA) 和不依赖复发活动的进展 (PIRA) 的风险更高.
与功能和幸福感相关的患者报告结果在40-50组中受到更大的影响.

结论:

与年轻人相比,在40-50岁时经历FDE的患者的炎症性疾病活动较小.
尽管炎症标志物较低,但老年患者面临神经退行性结果的风险更高.
年龄是MS病程和残疾累积的关键决定因素.

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