病毒性脑膜脑炎合并急性视网膜坏死临床特点(附病例报告1例)  

Study on clinical manifestations of acute retinal necrosis complicated with viral encephalitis,a case report

作　　者：韩春玉[1] 杨秀芬[2] 康智敏[1] 张春玲[1] 赵伟秦[1] 李继梅[1] 王艳玲[2] 

机构地区：[1]首都医科大学附属北京友谊医院神经内科,北京100050 [2]首都医科大学附属北京友谊医院眼科,北京100050

出　　处：《临床和实验医学杂志》2015年第18期1569-1571,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨病毒性脑炎合并急性视网膜坏死的病因、临床特点、影像表现、诊断及治疗。方法报道1例病毒性脑膜脑炎合并急性视网膜坏死患者的临床表现及诊治过程,总结临床特征并进行相关文献复习。结果患者为中年女性,临床表现、腰穿及头MRI结果提示为病毒性脑膜脑炎。脑膜脑炎发病20天后出现右眼视物不清,眼科会诊考虑急性视网膜坏死。经阿昔洛韦抗病毒及激素治疗,患者神经科症状体征好转,但右眼视力恶化,最终失明。结论病毒性脑炎合并的急性视网膜坏死病情重,治疗效果差,容易漏诊。早期诊断和及时的抗病毒治疗,有可能会改善患者预后。Objectine To explore the clinical manifestations,diagnoses and treatment of acute retinal necrosis（ARN）complicated with viral encephalitis. Methods One case of ARN complicated with viral encephalitis had been reported. The related references were reviewed,and the clinical features were summarized. Results A middle - aged female patient was diagnosed as encephalitis based on clinical manifestations,re-sult of lumber puncture and features of MRI. 20 days after the onset of encephalitis,deterioration of vision occurred in her right eye,hence the clinical diagnosis of ARN was made. After the application of antiviral agent acyclovir and glucocorticoid therapy,her neurological symptoms and signs had been improved,however,her visual acuity was deteriorated. Conclusion ARN complicated with viral encephalitis has very high preva-lence of blindness and it is easily be clinically missed. Early diagnosis and immediate antiviral therapy may improve the prognosis of this kind of patients.

关 键 词：病毒性脑炎 急性视网膜坏死 临床特点 

分 类 号：R512.3[医药卫生—内科学] R774.1[医药卫生—临床医学]