急性脱髓鞘性脑脊髓病53例回顾分析  

Retrospective Analysis of Acute Demyelinating Encephalomyelopathy

作　　者：赵江明[1] 任于果[2] 高宗良[2] 

机构地区：[1]安徽医科大学附属省立医院神经内科,安徽合肥230001 [2]安徽医科大学附属医院神经内科,安徽合肥230022

出　　处：《中国神经免疫学和神经病学杂志》2007年第5期243-245,共3页Chinese Journal of Neuroimmunology and Neurology

摘　　要：目的分析急性脱髓鞘性脑脊髓病的临床特点,探讨单相急性中枢神经系统(CNS)脱髓鞘性脑脊髓病临床亚组的特点,寻求较为准确可靠的诊断手段。方法收集近年收治的CNS急性脱髓鞘性疾病53例,对其临床特点、损害部位、实验室检查阳性结果以及影像学MRI的改变进行系统回顾分析。结果急性脱髓鞘性疾病53例中能做出临床诊断者46例,其中部分患者中枢和周围神经均受损害,难以按传统标准作出诊断,需密切随访。结论急性脱髓鞘性脑脊髓病是一组临床表现多样的免疫介导的炎性疾病,部分病例难以按传统标准做出诊断,有可能为临床孤立综合征(CIS)或其他亚组疾病,故尚需密切随访。MRI和脑诱发电位有重要诊断价值。急性期大剂量甲基强的松龙联合静脉丙种球蛋白治疗可取得一定疗效。Objective Analyzing the clinical manifestations of acute demyelinating encephalomyelopathy. Investigating the clinical characteristics and classifying different types of monophase acute demyelinating eneephalomyelopathy. Seeking effective and reliable diagnosis and treatment methods for acute demyelinating eneephalomyelopathy. Methods 53 patients of acute demyelinating encephalomyelopathy patients treated in recent years have been studied. Systematical investigations were conducted in the following areas： the clinical appearances, the damaged locations, the positive lab results and the MRI results. Results 46 patients have been firmly diagnosed. In some instances, the damages spread so widely that the central and peripheral nerves are affected. Traditional diagnostic methods are not sufficient in those cases so close follow-ups are necessary. Conclusions Acute demyelinating encephalomyelopathy is consisted of a group of immunization mediated inflammatory diseases which manifest themselves into different clinical appearances. Traditional methods are not sufficient for diagnosis in some instances and close follow-ups are necessary in those cases, which may be clinically isolated syndromes （CIS） or other subgroups. MRI and EPs are very important diagnostic techniques. Large dose of methylprednisolone combining with intravenous immunoglobulin （IVIG） is proven to have reasonable curative effect in the acute stage.

关 键 词：脱髓鞘病 急性播散性脑脊髓炎 多发性硬化 临床孤立综合征 

分 类 号：R744.5[医药卫生—神经病学与精神病学]