中枢神经系统炎症性脱髓化疾病的儿童急性症状发作和
Shangru Li1, Xuting Chang1, Jie Zhang1
1Children's Medical Center, Peking University First Hospital, Beijing 102627, China.
Multiple sclerosis and related disorders
|August 31, 2025
概括
患有中枢神经系统炎症性脱髓性疾病 (CIDD) 的儿童中,超过三分之一患有急性症状性 (ASS),特别是患有MOGAD或血清阴性CIDD的儿童. 在这些儿童中,发病率为9.9%.
科学领域:
- 儿童神经学
- 神经免疫学
- 脱素的疾病
背景情况:
- 中枢神经系统炎症性脱髓性疾病 (CIDDs) 包含一组影响大脑和脊髓的获得性免疫介导疾病.
- 急性症状发作 (ASS) 和是儿科CIDD的潜在神经复杂症,影响患者的结果.
- 了解这些的流行病学和风险因素对于及时诊断和管理至关重要.
研究的目的:
- 在被诊断为中枢神经系统炎症性脱髓性疾病 (CIDDs) 的儿童中确定急性症状性发作 (ASSs) 和的患病率.
- 确定与ASS发生和发育相关的临床和放射性风险因素.
- 在不同类型的CIDD中比较ASS的发生率.
主要方法:
- 在2013年1月至2024年6月期间,北京大学第一医院对被诊断患有CIDD的儿童进行了回顾性队列研究.
- 在不同CIDD分类的患者中评估和比较ASS的发生率.
- 分析了临床数据,包括发作特征,脑磁共振成像结果和病程,以确定ASS和的危险因素.
主要成果:
- 在204名患有CIDD的儿童中,有75名 (36.8%) 患有ASS. 这种发病率在髓寡细胞糖蛋白抗体相关疾病 (MOGAD) 和血清阴性CIDD中较高.
- 在急性传播性脑炎 (ADEM) 和大脑皮层脑炎 (CCE) 现型中出现的ASS更为频繁.
- 的总体患病率为9. 9%,多次脱髓发作是其发展的预测因素. 发烧和皮质干扰在MRI上是对ASS的独立保护因素.
结论:
- 在患有CIDD的儿童中,很大一部分患有ASD,MOGAD和血清阴性CIDD的发病率更高.
- 特定的临床表现如ADEM和CCE表型与ASS的风险增加有关.
- 是一种显著的长期并发症,影响近10%的儿童患有CIDD,特别是那些有复发性脱髓化事件的儿童.
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