散发型克-雅病1例报告并文献复习  

A case report of sporadic Creutzfeldt-Jakob disease and literature review

作　　者：丁静 王继鉴 苏潭 张上茂 陈元坚 胡延生 DING Jing;WANG Jijian;SU Tan;ZHANG Shangmao;CHEN Yuanjian;HU Yansheng(Youxi County General Hospital,Sanming 365100 Fujian,China)

机构地区：[1]尤溪县总医院,福建三明365100

出　　处：《中国民康医学》2023年第16期163-166,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:分析1例散发型克-雅病患者的临床诊疗过程,以提升临床医师对散发型克-雅病的早期识别和诊疗能力。方法:回顾性分析2020年7月13日该院收治的1例散发型克-雅病患者的临床资料和诊疗过程。结果:散发型克-雅病患者临床表现为进行性痴呆、行为异常和精神障碍等症状,头颅磁共振成像(MRI)扫描中弥散加权成像显示对称性或不对称性皮质“缎带征”,尾状核和壳核异常高信号;病程中晚期脑电图表现为周期性尖慢复合波;脑脊液14-3-3蛋白检测阳性。结论:临床需高度警惕克-雅病可能,散发型克-雅病患者在头颅MRI、脑电图、14-3-3蛋白检测上具有一定共性,可为临床无创诊断散发型克-雅病提供依据。Objective:To analyze the clinical diagnosis and treatment process of sporadic Creutzfeldt-Jakob disease so as to improve the early identification as well as the diagnosis and treatment ability of the clinicians for sporadic Creutzfeldt-Jakob disease.Methods:The clinical data and the diagnosis and treatment process of 1 case of sporadic Creutzfeldt-Jakob disease admitted to the hospital on July 13,2020 were retrospectively analyzed.Results:The patient with sporadic Creutzfeldt-Jakob disease had the following clinical manifestations,such as progressive dementia,behavioral abnormalities and mental disorders.The diffusion-weighted imaging(DWI)of brain magnetic resonance imaging(MRI)scan showed symmetrical or asymmetrical cortical“ribbon sign”and abnormal high signal in caudate nucleus and putamen nucleus.In the middle and late stages of the disease,the EEG showed periodic sharp and slow complex waves.The cerebrospinal fluid 14-3-3 protein detection was positive.Conclusions:Clinically,the possibility of Creutzfeldt-Jakob disease should be highly vigilant.Cranial MRI,EEG and 14-3-3 protein detection in the patients with sporadic Creutzfeldt-Jakob disease have certain commonalities,which can provide a basis for the clinical non-invasive diagnosis of sporadic Creutzfeldt-Jakob disease.

关 键 词：散发型克-雅病 朊病毒 磁共振成像 脑电图 14-3-3蛋白 诊断 

分 类 号：R742[医药卫生—神经病学与精神病学]