32例成人流行性乙型脑炎临床及影像学特点分析  

Clinical and Image Features of 32 Adult Patients With Japanese Encephalitis

作　　者：刘妍君[1] LIU Yanjun(Neurology Department,Lanzhou University Second Hospital,Lanzhou Gansu 730030,China)

机构地区：[1]兰州大学第二医院神经内科,甘肃兰州730030

出　　处：《中国卫生标准管理》2020年第24期60-64,共5页China Health Standard Management

摘　　要：目的分析成人流行性乙型脑炎患者的临床及影像学特点。方法回顾性分析兰州大学第二医院神经内科2017年7—9月期间收治了32例确诊为流行性乙型脑炎患者的临床资料进行回顾性分析,并进行随访,采用功能独立性检查(function independent measure,FIM)评定患者预后。结果流行性乙型脑炎患者的主要临床表现是发热32例,头痛28例,意识障碍11例,癫痫发作7例,运动障碍5例。脑脊液检查:白细胞数升高29例,蛋白升高27例。头颅MR提示病变累及丘脑20例,大多数呈双侧分布。出院后6个月,FIM评定结果:完全独立22例。结论流行性乙型脑炎常急性起病,进展快,病情危重,以高热、头痛、意识障碍、癫痫发作为主要症状。头颅MR提示特征性丘脑病变。少数患者留有认知障碍。Objective To analyze the clinical and imaging(magnetic resonance imaging,MRI)features of 32 adult patients with Japanese encephalitis(JE).Methods The clinical data for 32 patients diagnosed and treated with JE were retrospectively analyzed from July to September 2017 at the Department of Neurology,Second Hospital of Lanzhou University.Follow-up was performed and the functional independence measure(FIM)was used to assess patient prognosis.Results The main clinical manifestations of Japanese encephalitis patients were fever(32 cases),headache(28 cases),consciousness disorder(11 cases),seizures(7 cases),and movement disorders(5 cases).The test of cerebrospinal fluid(CSF)showed that white blood cell count increased in 29 cases and protein increased in 27 cases.Brain MRI demonstrated that lesions involved the thalamus were 20 cases,most of which were bilaterally distributed.6 months after discharge,FIM assessment results displayed that 22 cases were completely independent.Conclusion JE often exhibits acute onset,with rapid progression and critical illness that is characterized by high fever,headache,decline of impaired consciousness,and seizures.Brain MRI displayed characteristic thalamic lesions.A few of patients had cognitive impairment.

关 键 词：流行性乙型脑炎 临床特点 急性脑炎综合征 认知障碍 影像学特点 特征性丘脑病变 

分 类 号：R512[医药卫生—内科学]