急性播散性脑脊髓炎临床分析

Clinical Analysis of Acute Disseminated Encephalomyelitis

目的分析急性播散性脑脊髓炎的临床特点,提高诊疗。方法收集1999年1月-2010年1月住院的急性播散性脑脊髓炎患者42例,对其临床症状体征、实验室检查、影像学改变及治疗进行全面回顾性分析。结果 42例患者中5～14岁者11例(26.19%);15～40岁者20例(47.62%),感染后引起的23例(54.76%),无明显诱因占15例(35.71%);脑脊液23例(23/34,67.65%)异常;脑电图异常者27例(27/32,84.38%);CT检查阳性率26例(26/40,65.00%),MRI阳性率25例(25/28,89.29%);糖皮质素、丙种球蛋白治疗有效。结论急性播散性脑脊髓炎是一组临床表现多样的免疫介导的炎性疾病,脑脊液、MRI和脑电图有重要诊断价值。急性期大剂量皮质素、静脉丙种球蛋白治疗均有较好疗效。

Objective To analysis the clinical features of acute disseminated encephalomyelitis so as to improve medical treatment.Methods From January,1999 to January,2010,42 inpatients with acute disseminated encephalomyelitis were collected and their clinical data were analyzed retrospectively.Results Out of these 42 patients,11（26.19% ） were within 5 to 14 years,20（47.62% ）within 15 to 40 years;23（54.76% ）had definite infection,and 15（35.71% ）had no any causes;23（23/34,67.65% ）had abnormal cerebrospinal fluid;27（27/32,84.38% ）had abnormal electro-encephalograph;26 （26/40,65.00%）were CT positive,25（25/28,89.29%）MRI positive;corticosteroids and gamma globulin were effective in the treatment of disseminated encephalomyelitis.Conclusion Acute disseminated encephalomyelitis is a kind of inflammatory disease with various clinical manifestation and mediated by immune.Cerebrospinal fluid,MRI,and electro-encephalograph have important roles in its diagnosis.Large dose of corticosteroids and gamma globulin are effective in the treatment of acute disseminated encephalomyelitis.