肠道病毒71型感染手足口病合并急性弛缓性麻痹临床分析

The clinical characteristics of enterovirus 71 infected hand-foot-mouth disease with acute flaccid paralysis

目的探讨肠道病毒71型感染手足口病合并急性弛缓性麻痹的临床特点。方法对10例肠道病毒71型感染手足口病合并急性弛缓性麻痹的患儿进行临床观察,并作病原学、头颅和脊髓磁共振成像、神经电生理及脑脊液检查。结果 10例中8例为2岁以下儿童,瘫痪前期均伴发热和皮疹,单侧肢体瘫痪占70%,1周左右患肢运动功能开始恢复,轻症多于1～3个月完全恢复。磁共振成像及神经电生理检查结果与临床症状具有高度一致性,提供了神经受累的定位证据。所有病例随访4～12周,7例(70%)肌力恢复至Ⅴ级。结论急性弛缓性麻痹是肠道病毒71型感染手足口病的严重并发症,磁共振成像及神经电生理检查对评估病情及预后有重要价值。

Objective To analyze the clinical characteristics of acute flaccid paralysis（AFP）caused by enterovirus 71（EV71）infected hand-foot-mouth disease（HFMD）.Methods Ten HFMD patients complicated with AFP were enrolled.The clinical manifestations were observed.Meanwhile the etiology,magnetic resonance imaging（MRI）of skull and spinal,electroneurophysiology and cerebrospinal fluid examination were performed.Results Eight patients were under 2 years old in these 10 HFMD patients.All patients had fever and rash before paralysis.There was paralysis of single limbs in 70% patients.The motor function was started to recover in one week.The mild paralysis was recovered in one to three months.Findings of MRI and electroneurophysiology were highly in accordance with clinical symptoms and provided the evidence and location of nerve involvement.The myodynamia recovered to V grade in seven patients after 4 to 12 weeks of follow-up.Conclusions AFP is the serious complication of EV71 infected HFMD.MRI and electroneurophysiology have important value in evaluation of patients＇ condition and prognosis.