特发性急性横贯性脊髓炎21例临床分析  

Clinical Analysis of 21 Patients with Idiopathic Acute Transverse Myelitis

作　　者：王瑞金[1] 齐冬[1] 李尧[1] 张拥波[1] 

机构地区：[1]首都医科大学附属北京友谊医院神经内科,100050

出　　处：《中国临床神经科学》2015年第5期522-525,共4页Chinese Journal of Clinical Neurosciences

摘　　要：目的探讨特发性急性横贯性脊髓炎(IATM)的临床特征、脑脊液以及MRI特点。方法回顾性分析2004年1月至2014年1月住院治疗的21例IATM患者的临床资料。21例患者均行脊髓及头颅MRI检查,根据脊髓病灶长度,将患者分为纵向延伸横贯性脊髓炎(LETM)组和非LETM组。结果 21例患者中以女性为主[15例(71.4%)],平均发病年龄(45.3±14.4)岁。急性期以及终末随访,扩展残疾状态量表(EDSS)评分中位数分别为6.5分和2分;复发2例(9.5%);脑脊液白细胞增多7例(33.3%)。LETM组14例(66.7%),6例(28.6%)病灶小于3个椎体节段,平均脊髓受累椎体节段为4个。LETM组急性期和终末随访EDSS评分高于非LETM组(P=0.040,P=0.030);LETM组脑脊液白细胞计数高于非LETM组(P=0.024)。结论 IATM病好发女性,复发率低。Aim To investigate the clinical characteristics, cerebrospinal fluid and MRI findings in idiopathic acute transverse myelitis（IATM）. Methods The patients diagnosed with IATM during the period from January 1, 2004 to January 1, 2014 were retrospectively reviewed. Results Twenty-one IATM patients were identified. This cohort showed a female predominance（71.4%）. The age at disease onset was 45.3±14.4 years. The median Expanded Disability Status Scale（EDSS） score during the acute period and at last follow-up was 6.5 and 2, respectively. Two patients（9.5%） had a recurrence. Cerebral spinal fluid（CSF） analysis showed pleocytosis in 7 patients（33.3%）. Fourteen patients（66.7%） belonged to longitudinally extensive transverse myelitis（LETM）, six patients（28.6%） had lesion less than three vertebral segments. The mean vertebral segments were 4. Comparison between patients with LETM and Non-LETM showed that EDSS score during the acute period and final follow-up in LETM were higher than that in Non-LETM（P=0.040, P=0.030）. Furthermore, CSF leucocytes count in LETM was higher than that in Non-LETM（P=0.024）. Conclusion IATM in this cohort predominantly affected female, and the recurrence rate was low.

关 键 词：特发性急性横贯性脊髓炎 纵向延伸横贯性脊髓炎 磁共振成像 脑脊液 

分 类 号：R741[医药卫生—神经病学与精神病学]