论文部分内容阅读
目的 :探讨咪唑类驱虫药致神经系统脱髓鞘疾病的临床特点。方法 :对 46例咪唑类驱虫药致神经系统脱髓鞘疾病患者的临床表现、CT和MRI特征及治疗进行回顾性分析。结果 :46例中仅脑部症状者 38例占 82 6 % ,合并脊髓症状者 5例占 10 9% ,合并周围神经症状者 1例占 2 2 % ,仅表现为脊髓症状者 2例占4 3% ;CT阳性率 5 8% ,MRI阳性率 10 0 % ,病灶主要分布在大脑皮质下、侧脑室周围的白质内 ;肾上腺皮质激素治疗总有效率 97 8% ,甲基强的松龙冲击组显效率高于常规地塞米松治疗组 (P <0 .0 5 )。结论 :咪唑类驱虫药致神经系统脱髓鞘疾病主要表现为脑部弥散性受损的症状和体征 ,可累及脊髓和周围神经 ;驱虫药接触史及CT、MRI是诊断的关键 ;肾上腺皮质激素尤其是甲基强的松龙疗效显著。
Objective: To investigate the clinical characteristics of demyelinating diseases caused by imidazole deworming drugs in the nervous system. Methods: The clinical manifestations, CT and MRI features and treatment of 46 cases of demyelinating diseases caused by imidazole insecticide were retrospectively analyzed. Results: Among the 46 cases, only 36 cases had brain-like symptoms, accounting for 82.6%. Five cases had spinal cord symptoms, accounting for 109%. One case had peripheral neurological symptoms, of which 22 cases accounted for 22%. Only 2 cases showed symptoms of spinal cord. 3%. The positive rate of CT was 58% and the positive rate of MRI was 100%. The lesions mainly distributed in the cerebral cortex and white matter around the lateral ventricle. The total effective rate of corticosteroid treatment was 97.8% Group markedly higher efficiency than conventional dexamethasone treatment group (P <0. 05). Conclusion: The demyelinating diseases caused by imidazole deworming drugs mainly show the signs and symptoms of impaired brain diffuseness, which can affect the spinal cord and peripheral nerves. The contact history of anthelmintics and CT and MRI are the key points in diagnosis. The adrenal glands Corticosteroids, especially methylprednisolone significant effect.