63例脊髓亚急性联合变性患者治疗效果的短期电生理随访研究  

Study of 63 cases with subacute combined degeneration by short-term follow-up

作　　者：董梦琪 侯苗苗 李新毅 王军[3] DONG Mengqi;HOU Miaomiao;LI Xinyi;WANG Jun(Shanxi Bethune Hospital/Tongji Shanxi Hospital of Shanxi Academy of Medical Sciences/The Third Hospital of Shanxi Medical University,Taiyuan 030032,China;Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430030,China;The Second Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西白求恩医院(山西医学科学院同济山西医院)山西医科大学第三医院,山西太原030032 [2]华中科技大学同济医学院附属同济医院,湖北武汉430030 [3]山西医科大学第二医院,山西太原030001

出　　处：《中国实用神经疾病杂志》2023年第1期30-35,共6页Chinese Journal of Practical Nervous Diseases

基　　金：山西白求恩医院院级科研基金资助项目(编号:2021YJ09)。

摘　　要：目的 分析脊髓亚急性联合变性(SCD)患者的临床资料,探讨神经电生理指标与神经功能损害程度和预后的相关性。方法 收集63例SCD患者临床特征、实验室结果、电生理表现、影像学结果。结果 入院、第3个月和6个月随访时进行功能障碍评分(FDS),50岁以上患者的FDS评分高于50岁及以下患者;贫血患者在入院和第3个月随访时的FDS评分高于非贫血患者;第6个月随访时感觉神经异常组FDS评分高于正常组;入院和第3个月随访时,上肢和下肢体感诱发电位(SEP)异常组FDS评分高于正常组。长病程(>3个月)SCD患者感觉和运动神经异常率高于短病程(≤3个月),短病程患者的MRI异常率高于长病程。Hcy与入院FDS评分呈正相关。结论 四肢SEP异常、年龄>50岁、贫血、高同型半胱氨酸血症等因素与神经功能损害程度相关。感觉神经传导异常、长病程和年龄>50岁会影响SCD的短期预后。Objective To investigate the correlation between clinical data and neuroelectrophysiological indexes of patients with subacute combined degeneration(SCD)and the degree and prognosis of nerve function impairment.Methods The clinical characteristics,laboratory results,electrophysiological manifestations and MRI of 63 patients with SCD were collected.Results Patients over 50 years had higher scores than younger at admis⁃sion and 3-month follow-up visit.Patients with anemia had higher scores at admission and 3-month follow-up.At 6-month follow-up,scores in the sensory nerve abnormalities group were higher than those in the normal group.At admission and 3-month follow-up,the scores of abnormal upper and lower limb somatosensory evoked potential(SEP)were higher than those of the normal group.The rates of sensory and motor nerve abnormalities in patients with long course(>3 months)were higher than those in patients with short course(≤3 months).The rate of MRI abnormalities was higher in patients with short course than those with long course.Positive correlation was seen between homocysteine(Hcy)and the clinical severity scores on admission.Conclusion Abnormal SEP,age over 50 years,anemia,and hyperhomocysteine are related to the degree of neurological impairment.Abnormal sensory nerve conduction,long course of disease,and age greater than 50 years affect the short-term prognosis of SCD.

关 键 词：脊髓亚急性联合变性 电生理 贫血 同型半胱氨酸 体感诱发电位 

分 类 号：R744[医药卫生—神经病学与精神病学]