多发性硬化的诊断和分类标准

TheDiagnosticandClassificatoryCriteriaofMultipleSclerosis:,,,,,,,,,,,,,,,,,,,,,,:,,:;;;:R74415+1:C:100622963(2001)032134205111111111(MS):MS,:22;22[124],,11112:,2,,,,(),,(),,MSMS,,11211,MS,,[1,4]21,,[1]MS,,,MS(MS),MS,11311311(attack,bout,episode,exacerbation,relapse):(ö),24h1,[2](anacuteepisodeofnewdiseaseactivity):2001204215;:2001204220:(19372),,,(),19791980198021986,::,100730:[phone]()4312001783ChinJNeuroimmunol&Neurol2001,Vol.8,No.3©1994-2006ChinaAcademicJournalElectronicPublishingHouse.Allrightsreserved.(subclinicalorparaclinical)[2,3,5]256MS(16),63%(63%)70%(94%)38%(88%)44%(56%)29%(81%)[6],,:(hotbathtest)CTMRI,50,,MS,[2]11312:2,11[2]21,1,6MS[2,3]11313:,:,MS:(1)50Lhermitte(2)(steroanesthesia)(3)50,,(4)(5)(oscillopsia)(6),(7)40,[2]11314:,[2]11315:MS,,MS,:[2]11316:,,15d()[2],[3][2]11317(opticneuritis):,MS51%,78%[3]256MS16,63%[6]11318MS:MS,,MSMS,MS,[7],MS,MS[8,9]1271MS,109(9%)[9],256MS70%[6]MS:MS(,1212,11141);(MS3514,12713111);(36%17%);,(,38%,32%)(1018,1112),11,MS[9]11319:1050[1,3]1059[2]256MS,2911,1171397017%,4713%5312001783ChinJNeuroimmunol&Neurol2001,Vol.8,No.3©1994-2006ChinaAcademicJournalElectronicPublishingHouse.Allrightsreserved.[6]113110:10%[10]2ö31238[1]7917%268%73019,112[6]113111:IgGC()IgG[2],,2,,,IgGC()IgGMS[2]IgGIgG,IgG,(sarcoidosis)[2]301MS3CMS,IgG,3MS[11],MSIgGMS[12]MS[2]2,,[124]211(clinicallydefinite)MS1122212,1,1212(clinicallyprobable)MS11212,2112311,11213(laboratory-supporteddefinite)MS111,2,IgGöIgG212,1,IgGöIgG311,11,IgGöIgG214(laboratory-supportedprobable)MS112,IgGöIgG2111,IgGöIgG311,1,IgGöIgG215,2,216111,121,1,3311-(relapsing-remitting,RR)MS:112(121)1212MSFig1-1Relapsing2remittingMSwithcompleteremission212(6312001783ChinJNeuroimmunol&Neurol2001,Vol.8,No.3©1994-2006ChinaAcademicJournalElectronicPublishingHouse.Allrightsreserved.)21222MSFig1-2Relapsing2remittingMSwithincompleteremission312-(primary-progressive,PP)MS:11,(221)21,(222)2212MS,Fig2-1Primary2progressiveMS.Progressiveprogressionwithoutplateauandremission2222MSFig2-2Primary2progressiveMS.Occassionallywithplateauandslightremission313-(secondary-progressive,SP)MS2,,:11,(321)21(322)3212MS2,Fig3-1Secondary2progressiveMS.R2RMSwithcompleteremissionatbeginning,followedbyprogression3222MS2,Fig3-2Secondary2progressiveMS.R2RMSatbeginning,followedbyoccasionalrelapseandslightremission314-(progressive-relapsing,PR)MS,,:112(421)212(422)315(benign)MS15316(malignant)MS,2,;7312001783ChinJNeuroimmunol&Neurol2001,Vol.8,No.3©1994-2006ChinaAcademicJournalElectronicPublishingHouse.Allrightsreserved.:[1]McDonaldWI,HallidayAM.Diagnosisandclassificationofmultiplesclerosis[J].BritMedBull,1977,33(1):429.[2]PoserCM,PatyDW,ScheinbergL,etal.Newdiagnosiscriteriaformultiplesclerosis:guidelinesforresearchprotocols[J].AnnNeurol,1983,13(3):2272231.[3]SchumecherGA.ProblemsofexperimentaltrialsoftherapyinMS:reportbythepaneloftheevaluationofexperimentaltrialsoftherapyinMS[J].AnnNYAcadSci,1965,122:552.[4].[M].:,2000.2102236.[5]LublinFD,ReingoldSC.Definingtheclinicalcourseofmultiplesclerosis:resultofaninternationalsurvey[J].Neurology,1996,46(4):9072911.[6]ZhaoBX,LiuDS,HuWM,etal.MultiplesclerosisinChina:Aclinicalstudyof256cases[M].In:KuroiwaY,KurlandLT(eds).Multiplesclerosiseastandwest[M].Fukuoka:KyushuUniversityPress,1982.71281.[7]BrainR,WilkinsonM.Theassociationofcervicalspondylosisanddisseminatedsclerosis[J].Brain,1957,80:4562478.[8]KuhlendahlH,IschebeckW.Multiplesclerosisandothermisdiagnosesinspinalprocesses[M].In:KlugW,BrockM,KlingerM,etal.AdvancesinNeurosurgery2[M].NewYork:SpringerBerlinHeidelberg,1975.1832190.[9]PoserS,Herrmann2GremmelsI,WikstromJ,etal.Clinicalfeaturesofthespinalformofmultiplesclerosis[J].ActaNeurolScand,1978,57:1512158.[10]McAlpineD.In:McAlpineD,LumsdenDE,AchesonED.Multiplesclerosis:areappraisal[M].2ndedition.ChurchillLivingstone,Edinburgh,1972.812307.[11]XuXH,McFarlinDE.OligoclonalbandsinCSF.TwinswithMS[J].Neurology,1984,34(6):7692674.[12]XuXH,McFarlinDE.OligoclonalbandsinCSF.TwinswithMS[M].In:YearBookofNeurologyandNeurosurgery,1987.1662168.(133)molecularmimicryandautoimmunity[J].NEnglJMed,1999,341:2068.[2]VictorM,RopperAH.Multiplesclerosisandallieddemyelinativediseases[M].In:VictorM,RopperAH(ed).Adamsandvictor’sprinciplesofneurology.7thedition.McGram2Hill,Inc,2001.9542982.[3]RudickRA,CohenJA,Weinstock2GuttmanB,etal.Managementofmultiplesclerosis[J].NEnglJMed,1997,337:1604.[4],.[J].,1999,32:108.[5],,,.[J].,1999,32:3292331.8312001783ChinJNeuroimmunol&Neurol2001,Vol.8,No.3©1994-2006ChinaAcademicJournalElectronicPublishingHouse.Allrightsreserved.