垂体后叶素致脑桥中央或/和脑桥外髓鞘溶解症临床分析并文献回顾  

The Clinical Characteristics and Retrospective Analysis of Pituitrin-induced Central Pontine and / or Extrapontine Myelinolysis

作　　者：伏强[1] 李仲光[1] 王小木[2] 夏峰[2] 王津存[2] 

机构地区：[1]宝鸡市中医院神经内科,陕西宝鸡721004 [2]第四军医大学西京医院神经内科,西安710032

出　　处：《神经损伤与功能重建》2009年第4期262-264,共3页Neural Injury and Functional Reconstruction

摘　　要：目的:报道2例应用垂体后叶素后导致的脑桥中央髓鞘溶解症(CPM)及脑桥外髓鞘溶解症(EPM)患者的临床资料,探讨垂体后叶素与CPM、EPM的关系、发病机制及经验教训。方法:对2例确诊CPM、EPM患者的病史、临床表现、影像学资料进行全面分析及相关文献分析。结果:2例均在大剂量应用垂体后叶素后发病;2例均出现假性延髓麻痹及四肢瘫痪等典型CPM、EPM临床症状;其中1例与应用垂体后叶素后出现继发性低钠血症相关,而另1例无明显低钠血症。结论:垂体后叶素导致CPM、EPM可能与继发性低钠血症、脑血管痉挛、脑组织缺血有关;当患者出现假性延髓麻痹、四肢瘫痪症状,应注意有无使用垂体后叶素史,想到CPM、EPM的可能;在应用垂体后叶素时应严格掌握适应症,严格控制滴数。Objective：Two cases of pituitrin-induced central pontine and extrapontine myelinolysis （CPM and EPM） were reported. The relationship between pituitrin and CPM, EPM, the pathophysiological mechanism and relevant treatment have been explored. Methods： The medical history, clinical manifestations and imaging data of two confirmed cases of CPM, EPM were analyzed and the relevant reports was reviewed. Results：The presentation of the both 2 cases developed after the application of large doses of pituitrin. Both the cases showed typical symptoms such as pseudobulbia and quadriplegia. One case was associated with pituitrin induced secondary hyponatremia and the other one had no apparent hyponatremia. Conclusion：Pituitrin induced CPM, EPM may be associated with secondary hyponatremia, cerebral vasospasrn, or cereberal iscbemia. When patients present pseudobulbia, quadri- plegia after administration of pituitrin, the possible diagnosis of CPM or EPM should be considered. Total doses of pituitrin should be strictly controlled.

关 键 词：垂体后叶素 脑桥中央髓鞘溶解症 脑桥外髓鞘溶解症 

分 类 号：R741[医药卫生—神经病学与精神病学] R744[医药卫生—临床医学]