摘要
【目的】探讨麻痹性痴呆(GPI)患者的临床,实验室检测,脑电图及影像学改变特点,以提供早期诊断依据。【方法】回顾性分析5例经临床和实验室确诊的GPI患者的相关资料。患者智能的检测采用简易智力状态检查量表(MMSE)评分,入选条件是MMSE≤20分。【结果】:5例患者均有进行性记忆力减退,判断力和计算力下降和语言表达障碍等。糊涂4例,行为异常2例,幻觉2例,易冲动2例,抽搐发作2例。2例在3个月内出现明显痴呆,言语障碍。2例在5个月内出现糊涂,行为异常,言语表达障碍。1例半年后出现明显痴呆,人格改变及行为异常。头颅MRI检查5例均有不同程度脑萎缩,2例脑实质内多发异常信号,以双侧额叶,颞叶明显。脑电图3例广泛中度异常,1例广泛重度异常。【结论】慢性进行性痴呆进展快者,做血清及脑脊液快速血浆反应实验(RPR),血清梅毒螺旋体特异性抗体(TP-Elisa)检测是早期诊断麻痹性痴呆的关键。
[Objective] To explore the clinical and laboratory examination, electroencephalogram and ima- ging changes of general paresis of insane(GPI) in order to provide the evidence for early diagnosis. [Methods] Clinical data of 5 GPI patients diagnosed by clinical and laboratory examination were analyzed retrospectively. Mini-mental state examination(MMSE) score was used to evaluate the intelligence of the patients. The patients with MMSE≤20 were enrolled. [Results] There were 5 patients with progressive hypomnesia, the decreasing of judgement and calculation and language disorder, 4 patients with confusion, 2 patients with behavior disorder, 2 patients with hallucination, 2 patients with impulse and 2 patients with convulsive seizure. Dementia and language disorder obviously appeared in 2 patients within 3 months. Confusion, behavior disorder and language disorder appeared in 2 patients within 5 months. Dementia, personality change and behavior disorder obviously appeared in one case after half a year. Cranial MRI showed that all 5 patients had cerebral atro-phy in different degree and 2 patients bad multiple abnormal signals in cerebral parenehyma, especially in bilateral frontal and temporal lobe. Electroencephalogram showed that 3 patients had extensive middle abnormality and one patient had extensive severe abnormality. [Conclusion] Rapid plasma reaction(RPR) test in serum and cerebral spinal fluid and serum treponema pallidum specific antibody(TP-Elisa) examination for chronic progressive dementia patients who progress rapidly is the key of early diagnosis of GPI.
出处
《医学临床研究》
CAS
2012年第3期418-420,共3页
Journal of Clinical Research