带状疱疹性脊髓炎7例临床特征分析  

Clinical analysis of 7 cases of varicella-zoster virus myelitis

作　　者：朱纪婷[1] 林艾羽[1] 吴萱[1] 李智文[1] 

机构地区：[1]福建医科大学附属第一医院神经内科,福州350000

出　　处：《中国神经精神疾病杂志》2017年第11期672-675,共4页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的探讨带状疱疹性脊髓炎的临床特点、影像学特征、诊疗及预后。方法对7例带状疱疹性脊髓炎患者的临床资料进行回顾性分析,并进行临床随访。结果 7例患者均有特征性皮疹及脊髓损害症状。5例以皮疹首发,2例以脊髓损害症状首发。4例受累皮节与脊髓节段相符,3例受累皮节低于脊髓损害水平。7例脊髓MR均表现为受累脊髓节段性不规则长T_1、长T_2信号,2例有强化。胸髓病变5例,颈髓2例。7例患者均予激素治疗,5例患者同时予抗病毒治疗。经12~36个月(平均22.7±8.1个月)随访,5例患者痊愈,1例遗留双手指轻微麻木,1例遗留排尿困难。结论带状疱疹性脊髓炎常表现特征性的皮疹和脊髓症状,积极的抗病毒药物和皮质激素治疗,预后较好。Objective To investigate the clinical characteristics, diagnosis, treatment and prognosis of varicella zoster virus myelitis. Methods The clinical data of 7 varicella zoster virus myelitis patients were retrospectively analyzed and clinical follow-up was conducted. Results Seven patients had characteristic skin rash and symptoms of spinal cord injury. The initial symptoms including rash in 5 cases and spinal cord damage symptoms in 2 cases. The affected skin sections were consistent with the spinal cord segment in 4 cases, and below the level of spinal cord injury in 3 cases. All 7 cases were confirmed by spinal MRI with segmental spinal cord lesions as evidenced by long T~ and long T2 signals in the affected spinal cord including enhancing lesion in 2 cases. Lesions located in thoracic cord in 5 cases and in cervical cord in two cases. All patients received steroid hormone treatment. Among them, 5 patients received additional antiviral treatment. After 12-36 months follow-up, 5 cases were cured, 1 case left with sphincter dysfunction and 1 case with slight numbness of hands. Conclusion Varicella zoster virus myelitis is characterized by characteristic rash and spinal cord symptoms. Antiviral drugs and corticosteroid therapy can yield better prognosis.

关 键 词：带状疱疹 脊髓炎 疾病特征 治疗 

分 类 号：R744.3[医药卫生—神经病学与精神病学] R752.12[医药卫生—临床医学]