人类获得性免疫缺陷综合征神经系统并发症临床分析

Clinical analysis of acquired immunodeficiency syndrome with neurological complications

目的 探讨获得性免疫缺陷综合征 (AIDS)患者神经系统并发症的临床特征。方法 对1992年 1月至 2 0 0 1年 5月间确诊的伴有神经系统并发症的 5例AIDS患者进行临床分析。结果 5例中有 1例空泡性脊髓病 ,1例空泡性脊髓病伴痴呆 ,1例颅内结核瘤伴痴呆 ,1例脑梗死伴继发性癫痫及三叉神经痛 ,1例多发性运动感觉神经病。其中 2例空泡性脊髓病均为首发症状。结论 AIDS患者容易发生各种神经系统并发症 ,尤以空泡性脊髓病及痴呆多见 ,年轻突发痴呆患者尤其伴有机会性感染时需考虑该病的可能。对这些患者 ,应检查血抗人类免疫缺陷病毒 (HIV)抗体。

Objective To investigate the clinical features of acquired immunodeficiency syndrome (AIDS) with neurological complications. Methods Five with neurological complications out of 31 patients with confirmed AIDS in Shanghai area from 1992 to 2001 were analyzed. Results Of the five cases, there were one complicated with vacuolar myelopathy, one vacuolar myelopathy accompanied with dementia, one cerebral tuberculoma accompanied with dementia, one cerebral infarction accompanied with symptomatic epilepsia and trigeminal neuralgia, one polyneuropathy. Two of the vacuolar myelopathy are those showing first occurring manifestations. Conclusion AIDS patients are found at high risk of neurological complications, of which vacuolar myelopathy and AIDS related dementia are more common. If young patients who suddenly suffered from dementia, especially in patients accompanied with opportunistic infections, AIDS should be considered. In these cases serum HIV antibodies should be checked.