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目的分析急性播散性脑脊髓炎的临床特点,提高诊疗。方法收集1999年1月-2010年1月住院的急性播散性脑脊髓炎患者42例,对其临床症状体征、实验室检查、影像学改变及治疗进行全面回顾性分析。结果 42例患者中5～14岁者11例(26.19%);15～40岁者20例(47.62%),感染后引起的23例(54.76%),无明显诱因占15例(35.71%);脑脊液23例(23/34,67.65%)异常;脑电图异常者27例(27/32,84.38%);CT检查阳性率26例(26/40,65.00%),MRI阳性率25例(25/28,89.29%);糖皮质素、丙种球蛋白治疗有效。结论急性播散性脑脊髓炎是一组临床表现多样的免疫介导的炎性疾病,脑脊液、MRI和脑电图有重要诊断价值。急性期大剂量皮质素、静脉丙种球蛋白治疗均有较好疗效。
Objective To analyze the clinical features of acute disseminated encephalomyelitis and improve diagnosis and treatment. Methods A total of 42 patients with acute disseminated encephalomyelitis who were hospitalized from January 1999 to January 2010 were retrospectively analyzed for clinical signs and symptoms, laboratory tests, imaging changes and treatment. Results Of the 42 patients, 11 (5% ~ 14 years) had 11 cases (26.19%), 20 cases (47.62%) were 15 ~ 40 years old, 23 (54.76%) caused by infection and 15 (35.71% 23 cases (23/34, 67.65%) of cerebrospinal fluid were abnormal; 27 cases (27/32, 84.38%) had abnormal electroencephalogram; 26 cases (26/40, 65.00%) had CT examination; (25 / 28,89.29%); glucocorticoid, gamma globulin treatment is effective. Conclusions Acute disseminated encephalomyelitis is a group of immune-mediated inflammatory diseases with various clinical manifestations. Cerebrospinal fluid, MRI and EEG have important diagnostic value. Acute high-dose corticosteroids, intravenous gamma globulin treatment have a good effect.