| 占家炀,
，葛慧珍,
，桂梦翠,
，林婧,
，卜碧涛,.SARS-CoV-2感染后新发中枢神经系统脱髓鞘疾病分析[J].神经损伤功能重建,2024,(12):711-714 |
| SARS-CoV-2感染后新发中枢神经系统脱髓鞘疾病分析 |
| Analysis of Newly-onset Central Nervous System Demyelinating Disorders Following SARS-CoV-2 Infection |
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| DOI： |
| 中文关键词: 中枢神经系统 脱髓鞘 严重急性呼吸道综合征冠状病毒2 |
| 英文关键词: central nervous system demyelination SARS-CoV-2 |
| 基金项目: |
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| 摘要点击次数: 155 |
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| 中文摘要: |
| 目的：探索SARS-CoV-2感染后的中枢神经系统脱髓鞘疾病的临床特征。方法：选择2022年5月至2023
年5月我科收治的新发中枢神经系统脱髓鞘患者57例。其中37例在发病前1个月内感染过SARS-CoV-2，纳入
感染组；20例在发病前未感染过SARS-CoV-2，纳入对照组。收集2组临床资料、影像学资料进行比较分析，并
进行为期1年的随访。结果：感染组SARS-CoV-2感染与中枢神经系统脱髓鞘病变发生的中位间隔时间为13
（7, 20）d。2 组患者的部分脊髓症状和年化复发率存在差异；与对照组相比，感染组患者肢体瘫痪（22.1% vs
16.7%，P＜0.05）和大小便障碍（17.6% vs 5.6%，P＜0.05）发生率较高（P＜0.05），年化复发率较低[(0.00±0.35) vs
(0.00±0.69)，P＜0.05）；2组的其他临床症状、神经功能评分、免疫学指标、影像学病灶特征、电生理与眼科相关检
查、短期预后差异均无统计学意义（P＞0.05）。结论：SARS-CoV-2感染与中枢神经系统脱髓鞘的发生发展之间
存在关联，但两者的因果关系尚未可知。感染与未感染SARS-CoV-2病毒的脱髓鞘患者的临床特征差异不大，
仅部分脊髓症状和年化复发率存在一定差异。 |
| 英文摘要: |
| To investigate the clinical features of newly-onset central nervous system (CNS) demyelinating disorders post-SARS-CoV-2 infection. Methods: A total of 57 patients with newly diagnosed CNS demyelinating diseases admitted to our department from May 2022 to May 2023 were studied. Among these, 37 individuals
who contracted SARS-CoV-2 within a month preceding symptom onset constituted the infection group; meanwhile,
20 patients without prior SARS-CoV-2 exposure formed the control group. Clinical and radiological records of both
groups were gathered for comparative assessment, followed by a year-long surveillance. Results: The median time
span between SARS-CoV-2 infection and the manifestation of CNS demyelination in the infected group was 13 (7,
20) days. Disparities were observed in specific spinal manifestations and annual recurrence rates (ARR) between the
groups; specifically, the infection group exhibited elevated frequencies of limb paralysis (22.1% vs 16.7%, P<0.05)
and disturbances in bladder and bowel function (17.6% vs 5.6%, P<0.05) relative to controls (P<0.05), along with a
reduced ARR [(0.00 ± 0.35) vs (0.00 ± 0.69), P<0.05]; conversely, no statistically significant disparities emerged in
other clinical presentations, neurological evaluations, immunological markers, imaging characteristics, electrophysiological studies, ophthalmological tests, or short-term prognoses across the two groups (P>0.05). Conclusion: While
an association exists between SARS-CoV-2 infection and the emergence of CNS demyelinating conditions, the causal link remains undetermined. Clinically, demyelinating patients with and without SARS-CoV-2 infection largely
share similar profiles, save for select spinal symptoms and variations in ARR. |
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