慢性脊柱疾病患者筛查亚急性脊髓联合变性的临床研究

Screening subacute combined degeneration of spinal cord in patients with chronic spinal disease

目的评价血清维生素B12检测在筛查慢性脊柱疾病患者中亚急性脊髓联合变性(SCD)发病情况。方法选取慢性脊柱疾病患者1256例,常规进行血清维生素B12检查及病变部位MRI检查,排除SCD患病情况。结果 1256例患者中血清维生素B12异常者34例,其中升高9例,降低25例。维生素B12升高的9例均排除SCD(维生素B12中位数为1128.3pg/ml),维生素B12降低患者中最终确诊SCD3例(维生素B12中位数为87.4pg/ml),血清维生素B12正常患者中通过其他手段确诊SCD1例。结论检测血清维生素B12对于大规模慢性脊柱疾病患者筛查SCD具有一定临床意义。

Objective To evaluate the significance of screening subacute combined degeneration（SCD）of spinal cord with serum vitamin B12（VitB12）in patients with chronic spinal disease.MethodsSerum VitB12 and MRI of diseased area were performed in 1256 cases with chronic spinal disease for excluding SCD.Results Of 1256 cases,34 cases were with abnormal serum VitB12,in whom VitB12 was higher in 9 cases and lower in 25 cases.All of 9 cases with higher serum VitB12（median 1128.3pg/ml）were excluded for SCD.Of 25 cases with lower serum vitamin B12,3 cases were diagnosised as SCD（median 87.4pg/ml）.There was 1 SCD case diagnosised by other means in the patients with normal level of serum VitB12.ConclusionDetecting serum VitB12 is a significant method for large-scale screening for SCD in patients with chronic spinal disease.