钩端螺旋体L型脊髓炎(附15例报告)  

LEPTOSPIRA L-FORMS MYELITIS: A REPORT OF 15 CASES

作　　者：马登宏[1] 马骥[2] 汤郡[3] 吴国林[1] 张郁文[1] 刘晓林[1] 唐素兰[4] 宋秀宇[4] 林特夫[4] 

机构地区：[1]蚌埠医学院附属医院神经科,蚌埠233003 [2]蚌埠医学院附属医院蚌埠市三院 [3]中山医科大学微生物学教研室 [4]蚌埠医学院微生物学教研室

出　　处：《中国人兽共患病杂志》1999年第3期43-44,39,共3页Chinese Journal of Zoonoses

基　　金：卫生部资助

摘　　要：目的探讨钩体L型脊髓炎发病机理和防治。方法对15例钩体L型脊髓炎临床表现、实验室检查，并复习文献。结果急性及亚急性或慢性脊髓损害各7、8例，双下肢瘫7例，四肢瘫8例。均有明显的传导束型或节段到感觉障碍及排尿障碍。血培养钩体L型阳性8例，原型构体6例，尿培养：构体L型5例；CSF培养钩体L型5例；血清钩体MAT阳性7例。结论钩体L4脊髓炎的发生可能为构体L型直接损伤脊髓或供血血管，钩体L型致间质炎症病理损伤所致。甲硝哒唑易透过血脑屏障能损坏钩体DNA结构，可减少钩体病后发病。Aim To investigate the pathogenesis,treatment of leptospira L-forms myelitis. Methods Clinical and lab-oratory examination were made in 15 cases of leptospira L-forms myelitis and the patients were treated accordingly. ResultSIn climical examination,acute and subacute or chronic destruction of medulla spinalis were found in 7 and 8 cases,paraplegia in7,tetiaplegia in 8. Sensational disorder and conductive fasciculus type or segmental type disorder in urination of urinated wereobvious in all cases- ln blood use,L-forms were isolated in 8 cases,and leptospira in 6. In urine use,L-forms were isolated in5- In CSF culture L-forms were isolated in 6,serum MAT was positive in 7. Conclusion Leptospira L-forms myelitis may bedue to the direct damage of rnedulla or its blood supply by leptosipira L-forms. Metraidazobe can pass through blood-brainbarrier and destroy the DNA of leptospira.

关 键 词：钩端螺旋体 钩端螺旋体L型 脊髓炎 甲硝哒唑 

分 类 号：R514.406[医药卫生—内科学] R744.3[医药卫生—临床医学]