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并发于带状疱疹的脊髓炎很少见,它可渐进性地导致严重的麻痹和死亡.本文报告一例患带状疱疹引起的上行性麻痹合并脊髓炎,应用阿糖腺苷治疗迅速获得改善.患者男,66岁,于右胸皮肤出现带状疱疹,2周后发觉右腿无力,不能站立.以后病情逐渐扩大范围和加剧,波及右上肢、左腿、躯干,至8周时第4胸椎水平以下的感觉已受损害,第9周时出现排尿困难,右侧颜面感觉异常及麻木.带状疱疹血清补体结合抗体高达1/1024,脊髓液蛋白0.8g,颈椎和胸椎x线拍片,显示脊椎炎改变.第10周时开始应用阿糖腺苷(5mg/kg/日)连续治疗10天.治疗中无不良反应或血液学的改变.开始治疗3天内,颜面感觉异常消失,又2天后右臂及躯干感觉逐渐恢
Myelitis associated with shingles is rare, and it can progressively cause severe paralysis and death.This article reports an example of herpes zoster-associated ascending paralysis associated with myelitis, which was rapidly ameliorated by treatment with vidarabine. Male, 66 years old, appeared in the right chest skin herpes zoster, 2 weeks later found his right leg weakness, can not stand after the disease gradually expanded and aggravated, affecting the right upper limb, left leg, trunk, to the 4th week of the thoracic vertebra The following sensations have been impaired, with dysuria at week 9, abnormal sensations of the face on the right, and numbness. Herpes zoster serum complement binding antibody is as high as 1/1024, spinal fluid protein 0.8g, cervical and thoracic x-rays, Spondylitis change.At the beginning of week 10, continuous application of vidarabine (5mg / kg / day) for 10 days without any adverse reactions or hematological changes.After 3 days of starting treatment, facial sensation disappeared, and after 2 days Right arm and trunk feel gradually restored