脱髓鞘性脑病的临床和病理特征研究  

Clinical and Pathologic Characteristics of Demyelinating Encephalopathy

作　　者：李忠 蔡晓东 谢向前 

机构地区：[1]广东省茂名农垦医院神经内科,广东高州525200

出　　处：《海南医学》2006年第6期14-16,共3页Hainan Medical Journal

摘　　要：目的探讨脱髓鞘性脑病的临床表现与病理特征。方法回顾性分析54例脱髓鞘性脑病患者的临床和病理资料。结果患者伴有明显的精神障碍(70%)和运动障碍(78%),脑脊液检查26例(48%)异常,IgG升高7例(13%)。影像学检查显示脑白质多处不规则病灶,脑电图多表现弥漫性异常(91%),以θ波、δ波增多为主。3例病理学活检显示神经纤维髓鞘破坏、脱失,并有炎性细胞浸润。经治疗痊愈37例(69%),好转9例(17%),恶化5例(9%),死亡3例(5%)。结论脱髓鞘性脑病形式复杂多变,临床易误诊,结合影像学、脑电图、生化等检测有助于及早确诊和治疗。Objective To investigate the clinical and pathologic charactefistics of demyelinating encephalopathy. Methods The data of 54 patients witb demyelinating encephalopathy were analyzed retrospectively. Results Most of the patients showed obvious mental disorder（70%） and motor disorder（78%）. There were 26 eases （48%） of abnormality in the examination of cerebrospinal fluid and 7 cases （13%） of IgG increasing. Imaging analysis revealed irregular multiple lesions in white matter and electroencephalogram revealed diffuse disorder in brain, mainly with the increase of θ and δ wave. There cases of biopsies indicated myelinoclasis, demyelination and inflammatory infiltration. After treatment, 37 cases（69%） fully recovered, 9 cases（17%） improved, 5 cases（9%） worsened, 3 cases （5%） died. Conclusions The patterns of demyelinating encephalopathy axe complicated, which are easy to result in misdiagnosis. It should be determined for early-stage treatment combined with imaging, electroencephalogram, and biochemical examination.

关 键 词：脱髓鞘性脑病 影像学检查 脑电图 脑脊液 病理学活检 

分 类 号：R744.5[医药卫生—神经病学与精神病学]