神经系统白塞病的诊治  

Diagnosis and Treatment of Neuro-Beh?et's Disease

作　　者：钱雪琴 石向群[1] 

机构地区：[1]兰州军区兰州总医院神经内科,兰州730050

出　　处：《医学综述》2017年第19期3837-3842,共6页Medical Recapitulate

摘　　要：白塞病累及神经系统者称神经系统白塞病(NBD),发病机制至今未明,头痛为其最常见的临床表现,好发部位为脑干、基底核区、侧脑室旁白质等,脑干型是最常见类型。目前NBD尚无独立的诊断标准,多采用第八届国际白塞病会议确立的白塞病的诊断标准及2013年的白塞病国际标准。NBD无特异性实验室检查指标,抗髓鞘因子升高提示疾病活动,白细胞介素6增多者预后不佳。NBD的治疗尚无确切而有效的方案,总体预后较差。急性期可予以糖皮质激素冲击治疗,颅内压增高者配合脑室腹腔分流术,缓解期及预防复发则配合免疫抑制剂及中成药治疗。Behcet＇s disease involving the nervous system is called neuro-Behcet＇ s disease（ NBD）,the pathogenesis of which is still unknown,and headache is the most common clinical manifestation,with the primary sites of brain stem（ the most common type）,basal ganglia,lateral ventricle white matter. Currently,NBD has no independent diagnostic criteria,and the diagnostic criteria established by the eighth international symposium on Behcet＇s disease and 2013 international criteria for Behcet＇s disease standard are mostly used in clinical. NBD has no specific laboratory index,and increased antimyelin factor prompts disease activity,increased interleukin 6 prompts poor prognosis. There is no exact and effective treatment plan for NBD,and the overall prognosis is poor. Acute phase can be treated with glucocorticoid shock,and for patients with increased intracranial pressure can be treated with ventriculo-peritoneal shunt for hydrocephalus,immunosuppressive agents and proprietary Chinese medicines can be used for remission stage and prevention of recurrence.

关 键 词：神经系统白塞病 头痛 脑干 糖皮质激素 

分 类 号：R741[医药卫生—神经病学与精神病学]