麻痹性痴呆5例临床分析  

Clinical Analysis of 5 Patients with General Paresis of Insane

作　　者：吴哲[1] 韩学艳[2] 付贺飞[1] 李岩 罗小萌[3] 柳忠兰[1] 

机构地区：[1]中国医科大学附属第一医院神经内科,辽宁沈阳110001 [2]阜新市中心医院神经内科,辽宁阜新123000 [3]中国医科大学七年制95期3班,辽宁沈阳110001

出　　处：《医学临床研究》2012年第3期418-420,共3页Journal of Clinical Research

摘　　要：【目的】探讨麻痹性痴呆（GPI）患者的临床，实验室检测，脑电图及影像学改变特点，以提供早期诊断依据。【方法】回顾性分析5例经临床和实验室确诊的GPI患者的相关资料。患者智能的检测采用简易智力状态检查量表（MMSE）评分，入选条件是MMSE≤20分。【结果】：5例患者均有进行性记忆力减退，判断力和计算力下降和语言表达障碍等。糊涂4例，行为异常2例，幻觉2例，易冲动2例，抽搐发作2例。2例在3个月内出现明显痴呆，言语障碍。2例在5个月内出现糊涂，行为异常，言语表达障碍。1例半年后出现明显痴呆，人格改变及行为异常。头颅MRI检查5例均有不同程度脑萎缩，2例脑实质内多发异常信号，以双侧额叶，颞叶明显。脑电图3例广泛中度异常，1例广泛重度异常。【结论】慢性进行性痴呆进展快者，做血清及脑脊液快速血浆反应实验（RPR），血清梅毒螺旋体特异性抗体（TP-Elisa）检测是早期诊断麻痹性痴呆的关键。[Objective] To explore the clinical and laboratory examination, electroencephalogram and ima- ging changes of general paresis of insane（GPI） in order to provide the evidence for early diagnosis. [Methods] Clinical data of 5 GPI patients diagnosed by clinical and laboratory examination were analyzed retrospectively. Mini-mental state examination（MMSE） score was used to evaluate the intelligence of the patients. The patients with MMSE≤20 were enrolled. [Results] There were 5 patients with progressive hypomnesia, the decreasing of judgement and calculation and language disorder, 4 patients with confusion, 2 patients with behavior disorder, 2 patients with hallucination, 2 patients with impulse and 2 patients with convulsive seizure. Dementia and language disorder obviously appeared in 2 patients within 3 months. Confusion, behavior disorder and language disorder appeared in 2 patients within 5 months. Dementia, personality change and behavior disorder obviously appeared in one case after half a year. Cranial MRI showed that all 5 patients had cerebral atro-phy in different degree and 2 patients bad multiple abnormal signals in cerebral parenehyma, especially in bilateral frontal and temporal lobe. Electroencephalogram showed that 3 patients had extensive middle abnormality and one patient had extensive severe abnormality. [Conclusion] Rapid plasma reaction（RPR） test in serum and cerebral spinal fluid and serum treponema pallidum specific antibody（TP-Elisa） examination for chronic progressive dementia patients who progress rapidly is the key of early diagnosis of GPI.

关 键 词：痴呆/病因学 

分 类 号：R749.16[医药卫生—神经病学与精神病学]