62例脑型血吸虫病临床分析及诊断依据的探讨

To explore the normal of diagnosis of cerebralschistosomiasis

目的为脑型血吸虫病的临床诊断提供依据。方法搜集1997年～2004年间临床诊断为脑型血吸虫病例,对其临床诊断依据进行分析。结果62例均有血吸虫感染史和中枢神经系统症状,头颅CT和MRI检查异常率合计为98.51%(66/67),脑电图检查者中有异常表现为50%(3/6);COPT检查和IHA血清免疫学检查异常率合计为80.30%(53/66)。依据血吸虫感染证据、中枢神经系统症状及头颅CT(或头颅MRI)检查结果或病理检查结果作出临床确诊者占91.94%(57/62)。结论诊断脑型血吸虫病应综合分析,在血吸虫病流行区,青壮年有疫水接触史或感染史或治疗史,有中枢神经系统症状,行头颅CT或MRI检查显示异常者,同时排除其他脑部疾患应高度怀疑脑型血吸虫病的可能。

Objective To provide scientific evidences for clinical diagnosis of cerebral-schistosomiasis（CSM）.Methods Sixty-two CSM cases from 1997 to 2004 were collected and their clinical diagnosis meth-ods were analyzed.Results All the cases had the history of schistosomiasis infection,and the symptom of cen-tral nervous system.The total positive rate of CT and MRI examination of the cases was 98.51%（66/67）,the abnormal rate of EEG was 50% for the six cases checked（3/6）,and the total positive rate of COPT and IHA was 80.30%（53/66）.91.94 %（57/62） of the cases were clinical diagnosed by the infection history,the symptom of central nervous system,and the results of CT or MRI examination or pathology examination.Conclusion Comprehensive analysis should be used in CSM diagnosis.All the young cases from endemic ar-eas that had the history of contacting infectious water,the symptom of central nervous system,abnormal brain manifestations examined by CT or MRI and excluding other diseases,should be highly considered to be CSM.