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曾有报道AIDS患者病理上类似亚急性联合变性(ASCD)的空泡性脊髓病,但其病因仍不明。本文报道两例AIDS患者伴有脊髓综合征,并描述其临床和病理特性。例1,男性,37岁。入院前6个月已诊断为AIDS。入院时T38℃,口腔念珠菌感染。意识清晰,双下肢弛缓性截瘫。脑及腰椎CT正常,CSF混浊,红细胞340/mm~3,白细胞410/mm~3,其中多核占97%,蛋白500mg/dl,糖65mg/dl。血清巨细胞病毒(CMV)抗体效价为1∶256。死后病理学检查:三脑室底部色较暗,镜下见室管膜下层和其腹侧壁水肿、纤维蛋白渗出与坏死。血管周围和实质有单核和多核白细胞浸润,室管膜大量脱落而难以辨认。在大量非典型细胞、星形细胞、室管
It has been reported that AIDS patients with vacuolar myelopathy, pathologically similar to subacute combined degeneration (ASCD), but its etiology is still unknown. This article reports two cases of AIDS patients with spinal cord syndrome, and describes its clinical and pathological features. Example 1, male, 37 years old. Six months before admission, AIDS has been diagnosed. Admission T38 ℃, oral Candida infection. Consciousness, both lower extremity flaccid paraplegia. Cerebral and lumbar CT was normal, CSF was cloudy, red blood cells 340 / mm ~ 3, white blood cells 410 / mm ~ 3, of which 97% multi-core, protein 500mg / dl, sugar 65mg / dl. Serum cytomegalovirus (CMV) antibody titer is 1: 256. Postmortem pathological examination: the bottom of the third ventricle darker color, see the subependyme and its ventral wall edema, fibrin exudation and necrosis. Perivascular and virtually mononuclear and multicellular leukocyte infiltration, a large number of ependymal shedding and difficult to identify. In a large number of atypical cells, astrocytes, ventricular tubes