脑囊虫病患者吡喹酮治疗前后神经精神症状的对照分析

Comparative analysis of psychiatric symptoms pre-post-treatment of praziquantel in patients with cerebrocysticercosis

目的 :了解脑囊虫患者抗囊治疗前后神经精神症状的变化。方法 :133例经头颅 CT或 MRI及囊虫免疫试验确诊为脑囊虫病患者 ,分别接受 3～ 4个疗程的吡喹酮抗囊治疗 ,每疗程的吡喹酮总量为 12 0～ 180 mg/ kg,分 3～ 7d,每日 3次口服。每疗程间隔 1个月。收集每例患者抗囊治疗前及抗囊 3～ 4个疗程后的神经精神症状作对照分析。结果 :治疗前神经精神症状以头痛、头晕和癫痫发作最为常见 (分别占 82 .7%、4 5 .1%和 6 3.9%) ;抗囊治疗后 ,头痛、头晕、癫痫发作、恶心呕吐、神经衰弱症候群、视乳头水肿、抑郁症状、肌体运动障碍等神经精神症状均较抗囊治疗前明显减少 (P<0 .0 5～ 0 .0 1) ;有 3例治疗后出现痴呆 ,另 1例治疗前已有痴呆的患者经抗囊治疗后痴呆表现加重。结论 :吡喹酮抗囊治疗对脑囊虫病患者的大多数神经精神症状有效 ,但可能有诱发或加重痴呆的可能。

Objective:To realize the changes of psychiatric symptoms pro-post -treatment with praziquantel in patients with cerebrocysticercosis.Methods:Various psychiatric symptoms of pre-post-treatment with praziquantel were compared in 133 cases of cerebrocysticercosis confirmed by CT(or MRI)and immunologic test.The patients received orally praziquantel of one course dose of 120～180 mg/kg(during 3～7days given averagely)for 3～4 courses of treatment,one month interval in between course of treatment.Results:Before treatment most frequent symptoms were headache,dizziness and epileptic attack(82.7%,45.1% and 63.9%,respectively);after praziquantel treatment psychiatric symptoms including headache,dizziness,epileptic attack,nausea,vomiting,neurasthenia,papilledema.depression and dyskinesia were significantly decreased compared with pretreatment(P<0.05～0.01).Of the 133 cases 3 occurred dementia after treatment and dementia was aggravated in other one in which mild dementia had existed pretreatment.Conclusions:Praziquantel is effective for most psychiatric symptoms caused by cerebrocysticercosis,but dementia may be induced or aggravated.