急性播散性脑脊髓炎临床分析

【】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。【Abstract】ObjectiveToanalysistheclinicalfeaturesofacutedisseminatedencephalomyelitissoastoimprovemedicaltreatment.MethodsFromJanuary,1999toJanuary,2010,42inpatientswithacutedisseminatedencephalomyelitiswerecollectedandtheirclinicaldatawereanalyzedretrospectively.ResultsOutofthese42patients,11(26.19%)werewithin5to14years,20(47.62%)ithin15to40years;23(54.76%)haddefiniteinfection,and15(35.71%)hadnoanycauses;23(23/34,67.65%)hadabnormalcerebrospinalfluid;27(27/32,84.38%)hadabnormalelectro-encephalograph;26(26/40,65.00%)wereCTpositive,25(25/28,89.29%)MRIpositive;corticosteroidsandgammaglobulinwereeffectiveinthetreatmentofdisseminatedencephalomyelitis.ConclusionAcutedisseminatedencephalomyelitisisakindofinflammatorydiseasewithvariousclinicalmanifestationandmediatedbyimmune.Cerebrospinalfluid,MRI,andelectro-encephalographhaveimportantrolesinitsdiagnosis.Largedoseofcorticosteroidsandgammaglobulinareeffectiveinthetreatmentofacutedisseminatedencephalomyelitis.