脊髓亚急性联合变性9例诊疗分析

Analysis of nine cases of subacute combined degeneration in the spinal cord

目的探讨脊髓亚急性联合变性的特点。方法回顾性分析近10年广西中医药大学第一附属医院收治的脊髓亚急性联合变性患者9例,结合文献分析其病因、机制、临床表现及预后。结果男女患者比例7∶2,平均起病年龄59.55岁。8例患者均有脊髓后索受累体征。7例合并贫血,2例血清Vit B12升高。影像学及电生理检查可以帮助诊断。给予甲钴胺治疗后均有不同程度好转。结论脊髓亚急性联合变性是由Vit B12缺乏引起的神经系统变性疾病,中老年患者多见,呈慢性或亚急性起病。临床早期诊断、及时给予Vit B12治疗是改善本病预后的关键。

Objective To investigate the clinical characteristics of subacute combined degeneration in the spinal cord.Methods Nine patients subacute combined with degeneration in the spinal cord in the first affiliated hospital of Guangxi university of chinese medicine in recent 10 years were retrospectively studied in their etiology,mechanism,clinical features and prognosis. Results The mean age of onset was 59. 55 years and the male-to-female ratio was7∶ 2. The 8 cases all had signs of posterior funiculi involvement of spinal cord. Seven patients were complicated with anemia,2 patients＇ serum Vit B12 levels were elevated.Image and electrophysiologic study can help with diagnosis. The symptoms of all patients improved in different degree after treatment with mecobalamin. Conclusion Subacute combined degeneration of the spinal cord is a neurodegenerative disorder caused by lacking of Vit B12,which is more common in older patients,and the disease usually starts in a subacute or chronic way. Early diagnosis and immediate Vit B12 treatment is the key to improve the prognosis.