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目的 研究亚急性联合变性 (subacute com bined degeneration of the spinal cord,SCD)的病因、临床表现、血液和影像学改变。方法 对 4年间收治的 6例及国外同期报道的 8例 SCD患者的原始资料进行回顾性分析。结果 除血清维生素 B1 2 缺乏外 ,叶酸缺乏、NO麻醉、普通变异型免疫缺陷综合征以及血液中出现异常载钴胺蛋白也是发病原因。首发症状多为末梢型周围神经病 ,脊髓损害以后索最明显 ,侧索中锥体束、脊髓小脑束、脊髓丘脑束均可受累。脑及脊髓 MRI呈现白质脱髓鞘改变。结论 了解 SCD的病因、临床特征及 MRI表现对本病的及早诊治很有帮助。
Objective To study the etiology, clinical manifestations, blood and imaging changes of subacute com bined degeneration of the spinal cord (SCD). Methods The data of 6 cases admitted in 4 years and 8 cases of SCD reported in foreign countries were retrospectively analyzed. Results In addition to the lack of serum vitamin B1 2, folic acid deficiency, NO anesthesia, common variant immunodeficiency syndrome and abnormal load of cobalt contained in the blood protein is also the cause. Most of the first symptom of peripheral peripheral neuropathy, spinal cord injury after the most obvious cable, lateral pyramidal tract, spinocerebellar bundle, spinal cord bundle may be involved. Brain and spinal MRI showed white matter demyelination changes. Conclusion Understanding the etiology, clinical features and MRI findings of SCD is helpful for the early diagnosis and treatment of this disease.