以神经源性直立性低血压为首发症状的脊髓亚急性联合变性1例并文献复习

Subacute combined degeneration of spinal cord with neurogenic orthostatic hypotension as the first symptom:a case report and literature review

脊髓亚急性联合变性(SCD)是一种脱髓鞘性神经退行性病变,常由维生素B_(12)缺乏引起,神经源性直立性低血压(NOH)则是SCD的少见临床表现,是老年人较常见的一种疾病,尤其多见于神经退行性疾病患者,严重影响患者生活质量,对其早期诊断及正确治疗可避免给患者带来严重的不良后果。甘肃省人民医院收治1例以NOH为首发症状的因慢性萎缩性胃炎(CAG)而导致维生素B_(12)缺乏的53岁女性SCD患者,经系统性治疗后病情明显好转。因此,本病的诊疗要点在于早期诊断与及时干预并帮助患者建立治愈信心,以此为神经科临床医师提供参考建议。

Subacute combined degeneration of spinal cord(SCD)is a demyelinating neurodegenerative disease,which is often caused by vitamin B_(12) deficiency.Neurogenic orthostatic hypotension(NOH)is a rare clinical manifestation of SCD,which is a common disease in the elderly,especially in patients with neurodegenerative diseases,which seriously affects the quality of life of patients.Early diagnosis and correct treatment can avoid serious adverse consequences for patients.A 53-year-old female patient with vitamin B_(12) deficiency caused by chronic atrophic gastritis(CAG)with NOH as the first symptom was treated in Gansu Provincial Hospital.Her condition was significantly improved after systematic treatment.Therefore,the key point of diagnosis and treatment of this disease is early diagnosis and timely intervention to help patients build confidence in cure,so as to provide references and suggestions for neurologists.