脑囊尾蚴病患者抗囊尾蚴治疗前后脑电图及影像学对比研究  

Comparative study on EEG and neuroimaging of patients with cerebral cysticercosis before and after treatment

作　　者：王忠磊[1] 付婷霞[1] 胡颖新[1] 李桂玲[1] 毛德华[1] 谭文彬[2] 

机构地区：[1]山东省医学科学院、山东省寄生虫病防治研究所,济宁272033 [2]济宁医学院基础学院

出　　处：《中国血吸虫病防治杂志》2014年第3期311-313,319,共4页Chinese Journal of Schistosomiasis Control

摘　　要：目的观察脑囊尾蚴病患者抗囊尾蚴治疗前后脑功能和病理形态学改变。方法对412例脑囊尾蚴病患者抗囊尾蚴治疗前后的脑电图和影像学资料进行回顾性分析。结果 412例脑囊尾蚴病患者中,脑电图检查示轻、中、重度异常分别占40.53%、45.63%、13.84%;脑电波主要表现为弥漫性慢波和局限性慢波活动,或在异常背景上有少量散在或阵发性棘、尖波或棘-尖慢综合波。脑CT、MRI检查示单发小囊型占23.54%,多发小囊型占44.42%,脑炎型占13.59%,大、小囊并存型占4.85%,钙化型占2.18%,混合型占11.41%。脑囊尾蚴病患者经过3个疗程抗囊尾蚴治疗后复查,脑电图恢复正常和明显好转分别占79.85%和20.15%;CT、MRI检查发现77.18%的患者病灶全部吸收,20.63%的患者大部分病灶吸收,2.18%的患者病灶无变化,均为钙化型。脑内囊尾蚴感染处于急性期的单发和多发小囊型、脑炎型和大、小囊并存型抗囊尾蚴治疗效果好,混合型抗囊尾蚴治疗效果较差,处于钙化期的脑囊尾蚴病患者仅需进行对症治疗。结论脑囊尾蚴病患者脑电图表现为轻度至重度异常,脑CT、MRI检查以多发小囊型为主。经抗囊尾蚴治疗后,多数患者脑电图逐渐恢复正常,病灶全部吸收,但部分患者会留有少量钙化灶。Objective To study the changes of cerebral function and pathological morphology before and after the antiparasit-ic treatment with albendazole and praziquantel in patients with cerebral cysticercosis. Methods The data of EEG and neuroimag-ing of 412 patients with cerebral cysticercosis were retrospectively analyzed. Results Before the treatment,the mild abnormali-ty,moderate abnormality,and severe abnormality were observed in 40.53%,45.63% and 13.84% of the patients respectively, which mainly showed the diffuse or focal irregular slow waves,or epileptiform discharges found in the abnormal brain waves. CT/MRI manifestation could be divided into six types,including single sacculus type（23.59%）,multiple sacculus type（44.42%）, encephalitis type（13.59%）,coexistence of macrocyst and sacculus type（4.85%）,calcification type（2.18%）,and mixed type （11.41%）. After 3 courses of the treatment,the normal and improved EEGs were observed in 79.85%and 20.15%,respectively. CT/MRI showed the foci being all absorbed（77.18%）,being most absorbed（20.63%）,and being no changes（20.18%）which were calcified focus. When cerebral cysticercosis were in acute stage（the single and multiple sacculus type,encephalitis type, and macrocyst and sacculus coexistence type）,the therapeutic effect was good;while in the mixed type,the therapeutic effect was relatively poor. If cysticercosis were in the calcification stage,the patients only needed the heteropathy. Conclusions In the pa-tients with cerebral cysticercosis,EEGs show the mild to severe abnormalities,and CT/MRI mainly shows the multiple sacculus type. After the treatment,the abnormal EEGs are gradually recovered and the low density foci can be all absorbed,but some calci-fied focus still exist in some patients.

关 键 词：脑囊尾蚴病 抗囊尾蚴治疗 脑电图 影像学检查 对比研究 

分 类 号：R532.33[医药卫生—内科学]