脊髓亚急性联合变性24例临床分析

Analysis of Clinical Characteristics,Diagnosis and Prognosis of Subacute Combined Degeneration of the Spinalcord

目的探讨脊髓亚急性联合变性(SCD)患者的临床特点、诊断及预后。方法回顾性分析24例SCD患者的临床特点、辅助检查结果、治疗及预后。结果 21例血清维生素B12水平降低。17例行脊柱MRI检查,10例有异常信号,呈条带状等T1长T2异常信号。24例患者均给予维生素B12肌肉注射,14例治愈(58.3%),6例明显好转(25.0%),4例效果不明显(16.7%)。结论 SCD患者主要表现为脊髓后索、侧索受累,周围神经受累亦较常见。及时应用维生素B12治疗,症状可明显好转。本病为可治性疾病,预后与病程密切相关,应重视早期诊断、治疗。

Objective To explore clinical characteristics,diagnosis and prognosis of subacute com-bined degeneration of the spinalcord.Methods The data of 24 SCD patients were retrospectively analyzed on the clinical characteristics,results of assistant examinations,treatment and prognosis.Results There were 21 patients whose serum vitamin B12 level decreased.Ten of 17 cases performed with spine MRI examination showed linear T1 abnormal signal and long T2 abnormal signal.All 24 cases were treated by intramuscular injection with vitamin B12,and 14 cases are cured,6 cases are significantly improved,but the other 4 cases have no significant effect.Conclusion The major clinical manifestations of the patients with SCD were posterior column and funiculus lateralis involvement.Peripheral nerve involvement is also common.The patients＇ symptoms may be improved by timely therapy of vitmine B12.The disease is curable.The prognosis is closely related to the course of disease.The early diagnosis and therapy are very important.