多发性硬化症疾病标准的演变:潜在的动机和更广泛的影响
Kristofoor E Leeuwenberg1, Lennart H van der Molen2, Marianne Boenink2
1Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud Research Institute for Medical Innovation, Nijmegen, The Netherlands. kris.e.leeuwenberg@radboudumc.nl.
BMC neurology
|January 23, 2026
概括
多发性硬化症 (MS) 诊断标准已经发展,越来越多地依赖MRI而不是临床症状来早期诊断. 这种转变影响了疾病的理解和患者的护理,需要仔细考虑好处和风险.
科学领域:
- 神经学 神经学
- 医学诊断 医学诊断 医学诊断
- 卫生政策 卫生政策
背景情况:
- 多发性硬化症 (MS) 诊断标准在过去30年中发生了显著的变化.
- 生物标志物的整合,特别是磁共振成像 (MRI),在这些变化中起到了关键作用.
- 这些不断变化的标准对患者,医疗保健系统和社会产生了深刻的,往往未被认识到的影响.
研究的目的:
- 调查多发性硬化症 (MS) 诊断标准的历史变化.
- 探索这些修订的潜在动机和驱动因素.
- 讨论这些不断变化的诊断标准的更广泛影响.
主要方法:
- 从1983年到2024年对MS诊断标准的出版物的系统审查.
- 传统的内容分析,以检查每个标准修订的目标和动机因素.
- 评估每个诊断标准更新中的内容变化.
主要成果:
- 自2001年以来,MS诊断标准已经转向整合MRI,并使早期诊断成为可能.
- 标准越来越多地被设计为临床实践而不是仅仅是研究,受疾病修饰治疗的影响.
- 核磁共振已经成为MS诊断的核心,减少了临床症状的相对重要性.
结论:
- 不断变化的MS标准重新定义了疾病的概念化,并扩大了范围,包括像放射性隔离综合征 (RIS) 这样的疾病.
- 这些变化需要平衡早期诊断的好处与误诊的风险.
- 了解这些转变对于批判性地评估未来的修订和管理后果至关重要.
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