脊髓亚急性联合变性不同病程的临床表现和脊髓MRI检查结果的对照研究

A Comparative Study of Clinical Manifestations and MRI Findings of Subacute Combined Degeneration of Spinal Cord at Different Stages of the Disease

目的:观察比较脊髓亚急性联合变性(SCD)在病程不同时期的临床表现和MRI检查结果的差别。方法:选取2013年1月~2016年6月在我院住院治疗的SCD患者96例,根据病程将患者分为病程<3个月组(62例)和病程>3个月组(34例),比较两组患者不同时期的临床表现、MRI检查结果的差别。结果:两组患者的首发症状出现率相比较,差异均无统计学意义,P>0.05;两组患者的二便障碍的出现率相比较,差异有统计学意义,P<0.05;两组患者的周围神经感觉异常和感觉平面等体征相比较,差异有统计学意义,P<0.05;两组的MRI检查病灶出现率相比较,差异有统计学意义,P<0.05;两组治疗半年后的MRI复查治愈率相比较,差异有统计学意义,P<0.05。结论:在SCD病程早期,MRI检查更易发现病灶,因而更易治愈;病程晚期容易出现二便障碍、周围感觉异常和感觉平面等临床表现。

Objective： To observe and compare the clinical manifestations and MRI findings of subacute combined degeneration of the spinal cord （SCD） at different stages of the disease. Methods： From January 2013 to June 2016, according to the different stages of disease,96 cases of SCD patients in our hospital were divided into the stage of the disease 〈3 m group with 62 cases and the stage of the disease 〉3 m group with 34 cases, compared the clinical manifestations and MRI findings of the two groups at different stages of the disease. Results： Compared the first symptom of the two groups, there was no statistically significant differences, P〉0.05; the difference of disorder rate between the two groups was statistically significant, P〈0.05; and compared the peripheral nerve sensory abnormalities and sensory level and other signs of the two groups, the difference was statistically significant, P〈0.05. Compared MRI examination of the incidence of lesions of the two groups, the difference was statistically significant, P〈0.05; and after the treatment for six months, the difference between the cure rate of MRI review was statistically significant, P〈0.05. Conclusion： In the early course of SCD, MRI examination is more likely to be found, so it is easier to cure. In the late stage of the disease, the clinical manifestations such as urine and stool obstruction, abnormal peripheral sensation and plane sense perception may occur easier.