【摘要】 目的 分析急性播散性腦脊髓炎的臨床特點(diǎn)，提高診療。 方法 收集1999年1月-2010年1月住院的急性播散性腦脊髓炎患者42例，對其臨床癥狀體征、實(shí)驗(yàn)室檢查、影像學(xué)改變及治療進(jìn)行全面回顧性分析。 結(jié)果 42例患者中5～14歲者11例（26.19%）；15～40歲者20例（47.62%），感染后引起的23例（54.76%），無明顯誘因占15例（35.71%）；腦脊液23例（23/34，67.65%）異常；腦電圖異常者27例（27/32，84.38%）；CT檢查陽性率26例（26/40，65.00%），MRI陽性率25例（25/28，89.29%）；糖皮質(zhì)素、丙種球蛋白治療有效。 結(jié)論 急性播散性腦脊髓炎是一組臨床表現(xiàn)多樣的免疫介導(dǎo)的炎性疾病，腦脊液、MRI和腦電圖有重要診斷價(jià)值。急性期大劑量皮質(zhì)素、靜脈丙種球蛋白治療均有較好療效。
【Abstract】 Objective To analysis the clinical features of acute disseminated encephalomyelitis so as to improve medical treatment. Methods From January, 1999 to January, 2010, 42 inpatients with acute disseminated encephalomyelitis were collected and their clinical data were analyzed retrospectively. Results Out of these 42 patients, 11 (26.19% ) were within 5 to 14 years, 20 (47.62%) ithin 15 to 40 years; 23 (54.76%) had definite infection, and 15 (35. 71%)had no any causes; 23 (23/34, 67.65%) had abnormal cerebrospinal fluid; 27 (27/32, 84.38%) had abnormal electro-encephalograph; 26 (26/40, 65.00%) were CT positive, 25 (25/28, 89.29%) MRI positive; corticosteroids and gamma globulin were effective in the treatment of disseminated encephalomyelitis. Conclusion Acute disseminated encephalomyelitis is a kind of inflammatory disease with various clinical manifestation and mediated by immune. Cerebrospinal fluid, MRI, and electro-encephalograph have important roles in its diagnosis. Large dose of corticosteroids and gamma globulin are effective in the treatment of acute disseminated encephalomyelitis.
引用本文： 王衛(wèi)平. 急性播散性腦脊髓炎臨床分析. 華西醫(yī)學(xué), 2010, 25(7): 1264-1266. doi: 復(fù)制
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- 1. 王維治. 神經(jīng)病學(xué)[M]. 北京: 人民衛(wèi)生出版社, 2006: 1157-1160.
- 2. Singhi PD, Ray M, Singhi S, et al. Acute disseminated encephalomyelitis in North Indian children: clinical profile and follow-up[J]. J Child Neurol, 2006, 21(10): 851-857.
- 3. 梁金花, 馬娜, 劉遠(yuǎn)洪, 等. 成人急性播散性腦脊髓炎誤診分析[J]. 中國實(shí)用神經(jīng)疾病雜志, 2009, 12(2): 27-29.
- 4. 黃峻. 神經(jīng)內(nèi)科疾病診斷流程與治療策略[M]. 北京: 科學(xué)出版社, 2007: 149-151.
- 5. Divekar D, Bhosale S, Divate P. Recurrent acute disseminated encephalomyelitis[J]. Indian Pediatr, 2007, 44(2): 138-140.
- 6. Wingerchuk DM. The clinical course of acute disseminated encephalomyelitis[J]. Neurol Res, 2006, 28(3): 341-347.
- 7. 武洪林, 季學(xué)滿. 急性播散性腦脊髓炎的臨床、病理及CT和MRI表現(xiàn)[J]. 醫(yī)學(xué)影像學(xué)雜志, 2004, 14(6): 501-504.
- 8. 李瞿, 張朝東. 甲潑尼龍與丙種球蛋白聯(lián)合治療成人急性播散性腦脊髓炎的療效[J]. 實(shí)用藥物與臨床, 2009, 12(5): 365-367.