摘要
目的:探讨脊髓亚急性联合变性(SCD)的临床特点及早期联合诊断。方法:收集18例SCD患者的临床资料,分析SCD患者临床表现,检测血清维生素B12(VB12)、同型半胱氨酸(Hcy)和平均血红蛋白(MCH)水平及平均红细胞体积(MCV),进行电生理检查并分析其异常表现。结果:18例SCD患者中临床表现肢体麻木者12例,运动障碍者10例,视物模糊者1例,精神异常者4例,尿便障碍者2例。18例患者中血清VB12水平降低者9例(50.0%),Hcy水平升高者18例(100%),MCV升高者15例(83.3%),MCH水平升高者14例(77.8%),15例患者行神经电生理检查,结果均有阳性发现。结论:SCD患者缺乏特征性临床表现,根据血清VB12缺乏诊断率较低,联合检测Hcy、MCH和MCV水平及电生理检查对SCD早期诊断有重要意义。
Objective：To discuss the clinical manifestations and early combined diagnosis of subacute combined degeneration（SCD）of the spinal cord.Methods：The clinical data of 18 patients with SCD were collected,and the clinical manifestations and the levels of serum vitamin B12（VB12）and homocysteine（Hcy）,mean corpuscular hemoglobin（MCH）levels,and mean corpuscular volume（MCV）were detected.The abnormal appearence of electrophysiological examination of the SCD patients was analyzed.Results：There were 12 cases of limb numbness in 18 SCD patients,10 cases of motor disturbance,1 case of blurred vision,4 cases of mental abnormality,and2 cases of urinary disturbance.Among the 18 patients,the serum VB12 levels were decreased in 9 cases（50.0%）,the Hcy levels were increased in 18 cases（100%）,the MCV were increased in 15 cases（83.3%）and the MCH levels were increased in 14 cases（77.8%）.The results of neuroelectrophysiological examination in 15 patients were all positive.Conclusion：The patients with SCD lack of the characteristic clinical manifestations.The diagnosis rate of SCD is low by the lack of serum VB12,and the combined detection of serum VB12,Hcy,MCV,MCH and electrophysiological examination is of great significance for the early diagnosis of SCD.
作者
杜娜
毛西京
于挺敏
姚刚
DU Na;MAO Xijing;YU Tingmin;YAO Gang(Department of Neurology,Second Hospital,Jilin University,Changchun 130041,China)
出处
《吉林大学学报（医学版）》
CAS
CSCD
北大核心
2018年第4期806-809,共4页
Journal of Jilin University：Medicine Edition
基金
国家自然科学基金资助课题(81500953)
吉林省科技厅科技发展计划项目资助课题(20150520143JH)
