55例脑型血吸虫病临床分析

The analysis of clinical manifestation for 55 case of cerebralschistosomiasis

目的提高脑型血吸虫病的正确诊断率,减少脑血的误诊。方法收集了1980年11月-1998年9月的脑型血吸虫病55例,对其临床表现进行分析。结果本组病例中,20岁-40岁31例(占56％),男性47例(占85 5％),慢性型52例(占94.5％),单纯癫痫型22例(占38.1％),伴癫痫发作的混合型12例(占21.8％)。血吸虫病 COPT 和 IHA 检查阳性率分别为89.5％和70.4％。所有病例 B 超检查均发现有血吸虫肝损害现象。CT 与 MRI 影像学检查显示,脑血病灶主要发生在大脑顶叶、枕叶、及额叶,以顶叶受累最多。96.4％的患者吡喹酮(PQT)治疗后显效。结论脑型血吸虫病以青壮年多见,男性多于女性,以慢性型多见,COPT 和 IHA 免疫学检查有助于脑血鉴别诊断,B 超、CT 与 MRI 影像学检查可作为重要的辅助诊断方法。

Objective To increases coincidence rate of diagnosis of cerebralschistosomiasis(CSM) and lessen the misdiagnosis of CSM.Methods 55 case of CSM clinically diagnosed from Nov.1980 to Sep.1998 were collected and their medical history were analyzed.Results Among the case,31 cases (56%)were aged from 20 to 40 and 47 cases(85.8%) are males.52 cases appeared in chronic CSM,22 cases (38.1%) appeared in simple epilepsy and 12 cases (21.8%) were mixture with epilepsy.The postive rate of COPT and IHA for schistosomiasis japonica was 89.5% and 70.4% rspectively .The pictures of B showed that all cases have hepatic injury.The results of CT and MRI showed that the focus that were mainly located in parietal lobe which wererbetter effects in PQT for 96.4% of 55 case.Conclusion The CSM are mostly occurred in young and male people,more cases appeared in chronic pattern.Both of COPT and IHA are benefit to diagnosis CSM.examination of B ultrasonography.CT and MRI can be used as import methods.