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目的探讨钩体L型脊髓炎发病机理和防治。方法对15例钩体L型脊髓炎临床表现、实验室检查，并复习文献。结果急性及亚急性或慢性脊髓损害各7、8例，双下肢瘫7例，四肢瘫8例。均有明显的传导束型或节段到感觉障碍及排尿障碍。血培养钩体L型阳性8例，原型构体6例，尿培养：构体L型5例；CSF培养钩体L型5例；血清钩体MAT阳性7例。结论钩体L4脊髓炎的发生可能为构体L型直接损伤脊髓或供血血管，钩体L型致间质炎症病理损伤所致。甲硝哒唑易透过血脑屏障能损坏钩体DNA结构，可减少钩体病后发病。
Objective To investigate the pathogenesis and prevention of L-myelitis in leptospira. Methods The clinical manifestations, laboratory examinations and review of 15 cases of L-myelitis were reviewed. Results Acute and subacute or chronic spinal cord injury in 7,8 cases, double lower limb paralysis in 7 cases, quadriplegia in 8 cases. There are obvious conduction beam or segment to sensory dysfunction and voiding dysfunction. There were 8 positive cases of L type in blood culture, 6 prototypical structures, 5 urolithiasis: L type in CSF, 5 cases of L type in CSF culture and 7 cases of MAT in serum. Conclusions The occurrence of L4 myelitis may be caused by the pathological damage of L-type interstitial inflammation caused by the L type of body directly injured spinal cord or blood vessels. Metronidazole easily through the blood-brain barrier can damage the hook body DNA structure, can reduce the incidence of leptospirosis.