Abstract
Objective: To explore the factors influencing the degree of disability in patients with multiple sclerosis (MS), and to provide evidence for its early diagnosis, prognostic evaluation and clinical intervention.Methods: This retrospective observational study included 72 patients with relapsing-remitting multiple sclerosis (RRMS) at the First Hospital of Shanxi Medical University. All patients completed craniocerebral and spinal cord MRI (with or without Gd enhancement) and were evaluated for Expanded Disability Status Score (EDSS) scores before receiving treatment.Results: Among 72 patients with RRMS, 45 (62.5%) had an EDSS score ≤3; A total of 27 patients (37.5%) had an EDSS score >3 points. Univariate analysis showed that age, annual recurrence rate (ARR), drug use, albumin (ALB), triglycerides (TG), and total number of lesions in groups with EDSS score ≤3 were significantly different from those with an EDSS score > 3 points (P < 0.05). Multivariate logistic regression analysis showed that ALB, total number of lesions, and drug use were independent influencing factors of the degree of disability in patients with MS, and the difference was statistically significant (P < 0.05). An ROC curve was constructed using ALB and the total number of lesions. The AUC of ALB was 0.681, P < 0.05, and the best cut-off value was 44.2 g/L. Its sensitivity to predict the degree of disability in patients with multiple sclerosis was 85.2%, while its specificity was 51.1%. The AUC of the total number of lesions was 0.665 (P < 0.05) and the best cut-off value was 5.5. Its sensitivity to predict the degree of disability in patients with multiple sclerosis was 70.4%, while its specificity was 64.4%. The AUC of the combined ALB, total number of lesions, and drug use was 0.795 (P < 0.05), sensitivity was 77.8, and specificity was 73.3%. The optimal diagnostic cut-off value of the regression equation for the EDSS score of patients with multiple sclerosis was 0.420.Conclusion: Serum ALB, total number of lesions, and drug use in patients with multiple sclerosis were independent factors influencing the degree of disability. These findings provide clinical evidence for the prognostic evaluation and early intervention of patients with multiple sclerosis.
Highlights
Multiple sclerosis (MS) is a neurodegenerative autoimmune central nervous system disease characterized by inflammation, demyelination, and axonal degeneration (1)
Quantitative data conforming to normal distribution were represented by mean ± standard X ± S deviation, and comparison between groups was performed using a t-test; Quantitative data conforming to non-normal distribution was represented by the median and interquartile range. [M(P25-P75)] indicates that the Mann-Whitney U test was used for comparison between groups
Univariate analysis showed that age, ARR, number of relapses, disease duration, drug use, ALB, TG, and total number of lesions in groups with an EDSS score ≤ 3 were significantly different from those with an EDSS score > 3 (P < 0.05)
Summary
Auxiliary Examination All patients used 1.5T field strength instruments to perfect the head MRI (T1WI, T2WI, Gd-DTPA enhancement) and spinal cord MRI scans. A blood test for serum total protein (TP) (biuret endpoint method), albumin (ALB) (bromocresol green method), prealbumin (PAB) (turbidimetric method), triglycerides (TG) (enzymatic method: GPO-POD), total cholesterol (TC) (cholesterol oxidase method), high-density lipoprotein cholesterol (HDL) (direct method) and lowdensity lipoprotein cholesterol (LDL) (direct method) was performed. Recording Data General demographic data: gender, age, BMI, ARR and drug use; laboratory tests: four blood lipids (TC, TG, HDL, LDL), TP, ALB and PAB; Total number of cranial MRI lesions with low or equal signals on T1WI and high signals on T2WI (hereinafter referred to as the total number of lesions), number of Gd-enhanced lesions and number of spinal MRI lesions
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