摘要
目的探讨脊髓亚急性联合变性(SCD)的病因、临床特征、MRI表现及治疗预后。方法对23例SCD患者的临床资料进行回顾性分析。结果 23例均有后索、侧索及周围神经损害,其中有4例出现性格改变、痴呆精神症状。56.5%(13/23)的患者有贫血,60.9%(14/23)的患者有胃部疾病(萎缩性胃炎8例,胃切除术后6例),65.2%(15/23)的患者血清VitB12水平降低,82.6%(19/23)的患者肌电图有异常改变,86.9%(20/23)脊髓MRI检查均在不同节段后侧索有明显长或等T1长T2信号的改变。23例患者给予维生素B12治疗,10例患者临床症状消失,8例症状明显改善,3例症状轻度改善,2例效果不明显。结论 SCD的诊断除了典型的脊髓后索侧索损害、周围神经损害和巨幼红贫血症状外,结合血清VitB12水平测定、胃镜检查、电生理检查、脊髓MRI检查,基本可以确诊。早期诊断及补充维生素B12等综合治疗可明显改善预后。
Objective To investigate the etiology,clinical manifestations,MRI features,treatment and prognosis of subacute combined with degeneration（SCD）.Methods The clinical data of 23 patients were carried out by retrospective analysis.Results There were all existed posterior cord,lateral funiculus and peripheral lesion in these cases,and 4 of them showed character transformation,dementia and psychiatric symptom,included anemia（13/23）,gastritis [atrophic gastritis（8/23）,postgastrectomy（6/23）],low serum vitaminViamin B12 assay（15/23）electromyogram（EMG）varing（19/23）,change of mild or hyperintensity onT1WI,hyperintensity on T2WI in different segment of dorsolateral funiculus（20/23）.After Vitmin B12 therapy for all the caces,there were 10 patients whose clinical symptoms disappeared,improved obviously（8/23）,improved slightly（3/23）,improved unconspicuous（2/23）.Conclusion Except for the typical posterior cord,lateral funiculus,peripheral lesion and megaloblastic anemia,considering the determination of vitamin B12,gastroscopy,electrophysiologic study,spinal cord MRI,the diagnosis of SCD should be sure on the whole.Early diagnosis and combined therapy as B12 therapy can improve SCD evidently.
出处
《中国现代药物应用》
2011年第7期10-12,共3页
Chinese Journal of Modern Drug Application
关键词
脊髓亚急性联合变性
VitB12缺乏
脊髓MRI
Subacute combined with degeneration
Vitamin B12 deficiency
Magnetic resonance imaging
