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目的探讨脊髓亚急性联合变性的特点。方法回顾性分析近10年广西中医药大学第一附属医院收治的脊髓亚急性联合变性患者9例,结合文献分析其病因、机制、临床表现及预后。结果男女患者比例7∶2,平均起病年龄59.55岁。8例患者均有脊髓后索受累体征。7例合并贫血,2例血清Vit B12升高。影像学及电生理检查可以帮助诊断。给予甲钴胺治疗后均有不同程度好转。结论脊髓亚急性联合变性是由Vit B12缺乏引起的神经系统变性疾病,中老年患者多见,呈慢性或亚急性起病。临床早期诊断、及时给予Vit B12治疗是改善本病预后的关键。
Objective To investigate the characteristics of spinal subacute combined degeneration. Methods Nine cases of subacute combined degeneration of spinal cord admitted to the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine in the past 10 years were retrospectively analyzed. The etiology, mechanism, clinical manifestation and prognosis were analyzed based on the literature. Results The male-female ratio was 7: 2, with an average onset age of 59.55 years. All 8 patients had signs of spinal cord involvement. Seven patients with anemia, two cases of serum Vit B12 increased. Imaging and electrophysiological examination can help diagnose. Given mecobalamin treatment have improved to varying degrees. Conclusions Subacute combined degeneration of the spinal cord is a neurodegenerative disease caused by Vit B12 deficiency. Middle-aged and elderly patients are more common and have chronic or subacute onset. Clinical early diagnosis, timely administration of Vit B12 is the key to improving the prognosis of this disease.