摘要
目的:分析脊髓亚急性联合变性的临床特点,评估不同治疗方案的效果。方法:34例SCD患者随机分为常规组和鞘内组,均给予常规治疗,鞘内组还予鞘内注射药物,对其临床资料及疗效进行分析。结果:32.4%(11/34)的SCD患者有贫血,58.8%(20/34)的患者MCV、MCH、RDW-SD均升高,67.6%(23/34)的患者血清Vit B12水平降低,34.4%(11/32)颈髓后部斑片状或长条状异常信号,25.0%(7/28)胸髓后部有异常信号,肌电图阳性率85.7%(24/28),体感诱发电位阳性率87.0%(20/23)。治疗后2组的神经功能评分较治疗前均有明显提高(P<0.05),且鞘内组较常规组提高更显著(P<0.05)。结论:Vit B12水平可以作为诊断SCD的有力证据,MCV、MCH及RDW可以作为SCD诊断的参考指标。脊髓MRI阳性率较低;肌电图及SEP等检查可协助诊断。静脉补充VitB_(12)是治疗SCD的有效手段,且静脉给药联合鞘内注射治疗SCD疗效更为显著。
Objective：To analyze the clinical characteristics of subacute combined degeneration of the spinal cord （SCD）,and to assess the clinical effectiveness of different therapies. Methods： Thirty-four patients diagnosed to have SCD were randomly divided into routine group and intrathecal group. The 2 groups were given routine treat-ment,and the intrathecal group was given intrathecal injection. The clinical data and effectiveness were analyzed. Results： Anemia was detected in 32.4%（11/34）patients. Increase of MCV, MCH, RDW-SD was seen in 58.8% pa-tients（20/34）. Low serum levels of VitB12 were observed in 67.6% patients（23/34）. Abnormal changes in the cervi-cal spinal segments on MRI was present in 34.4% patients （11/32）, and abnormal thoracic signal in 25.0% patients （7/28）. The decrease of nerve conduction velocity was observed in 85.7% patients （24/28）. Somatosensory evoked potentials （SEP） was showed abnormalities in 87.0% patients （20/23）. All the patients showed improved clinical symptoms as revealed by increased FDS scores （P〈 0.05）. The intrathecal group improved much better effects than the routine group （P〈 0.05）. Conclusion： Vitamin B12 level can be used as a powerful marker for the diagnosis of SCD. MCV, MCH and RDW can be used as references for diagnosis. Abnormal signals on MRI of the spinal cord are occasionally seen. Intravenous injection of VitB12 is effective, and intrathecal injections in combination with in-travenous administration increase the efficacy.
出处
《神经损伤与功能重建》
2015年第6期499-502,共4页
Neural Injury and Functional Reconstruction
