论文部分内容阅读
目的:分析国内原发性胼胝体变性(MBD)的症状、体征及影像学检查等临床特点,提高临床诊断的准确性。方法:借鉴循证医学系统评价方法,对1990~2013年国内文献报道的临床病例资料及重庆医科大学附属第一医院神经内科2009~2012年临床诊断为原发性胼胝体变性的住院病历资料进行综合分析。结果:剔除可能重复的病例后,共收集到133例,其中完整病例资料89例,5例来自重庆医科大学附属第一医院病历记录,84例来自文献报道。其中男83例,女6例,平均年龄47岁。主要症状依次有认知功能障碍52例(58.4%),精神行为异常29例(32.6%),意识障碍27例(30.3%),吐词不清26例(29.2%),反应迟钝26例(29.2%),癫痫发作22例(24.7%)等。57例头颅MRI均为阳性,“夹心征”为特征性改变。结论:MBD临床症状复杂多样,无特异性,认知功能障碍、精神行为异常、意识障碍较多见,绝大多数有长期大量饮酒史,有特征性影像学表现,MRI检查对早期诊断有重要价值,结合饮酒史、常见临床症状及头颅MRI检查,MBD可早期诊断,大剂量B族维生素治疗有效,明显改善预后。
Objective: To analyze the clinical features of the symptoms, signs and imaging examination of domestic primary corpus callosum degeneration (MBD) and to improve the accuracy of clinical diagnosis. Methods: Based on the evidence-based medical systematic evaluation method, the clinical data of cases reported in the domestic literature from 1990 to 2013 and the inpatient medical record data of the clinical diagnosis of primary corpus callosum degeneration in the Department of Neurology, the First Affiliated Hospital of Chongqing Medical University from 2009 to 2012 were summarized analysis. RESULTS: A total of 133 cases were excluded after the possible cases were repeated, of which 89 cases were complete, 5 cases were from the First Affiliated Hospital of Chongqing Medical University, and 84 cases were reported from the literature. There were 83 males and 6 females, with an average age of 47 years. The main symptoms were cognitive dysfunction in 52 cases (58.4%), mental disorders in 29 cases (32.6%), disturbance of consciousness in 27 cases (30.3%), vomiting unclear in 26 cases (29.2% 29.2%), seizures in 22 cases (24.7%) and so on. 57 cases of MRI were positive head, “sandwich sign ” as the characteristic changes. Conclusion: The clinical manifestations of MBD are complex and diverse, nonspecific, cognitive dysfunction, mental disorders, disturbance of consciousness more common, the vast majority have a long history of heavy drinking, there are characteristic imaging findings, MRI examination is important for early diagnosis Value, combined with drinking history, common clinical symptoms and cranial MRI examination, MBD early diagnosis, high-dose B vitamins effective, significantly improve the prognosis.