摘要
目的:分析亚急性联合变性(subacutecombineddegeneration,SCD)患者的临床、电生理特点,评价电生理在诊断SCD的价值。方法:收集33例解放军医院临床确诊的SCD患者临床资料。28例测血浆维生素B12、叶酸水平。所有患者行肌电图、胫神经体感诱发电位检查,11例行视觉诱发电位(VEP)检查,6例行听觉诱发电位(BAEP)检查。采用美国SPSS12.0统计软件,进行相关分析。结果:所有针极肌电图均正常,运动神经传导异常32根,感觉神经传导异常52根,胫神经SEP异常58侧,VEP异常14侧,BAEP异常5侧。血浆维生素B12低于正常21例,叶酸低于正常7例。经统计学处理病程与神经系统损害程度相关系数pearson=0.036,P=0.84,无明显相关。红细胞比容与神经系统损害程度相关系数pearson=0.395,P=0.023。结论:临床诊断SCD要综合各项实验室检查,而神经电生理对SCD的病变部位的判断、治疗前后病情变化均很有价值。
AIM:To analyze the clinical manifestation and electrophysiologic features of patients with subacute combined degeneration(SCD), and assess the value of electrophysiology in diagnosing SCD. METHODS:The clinical data of 33 patients, who were diagnosed to have SCD in the General Hospital of Chinese PLA, were collected.Plasma vitamin B12 and folate acid level were measured in 28 cases,electromyogram(EMG),somatosensory evoked potentials of tibial nerve were examined in all the patients,visual evoked potentials(VEP) and brainstem auditory evoked potential(BAEP) were performed in 11 and 6 cases respectively.Correlation analysis was performed by using the software of America SPSS 12.0. RESULTS:Needle EMG was normal in all the cases,motor nerves conduction and sensory nerves conduction were abnormal in 32 and 52 cases respestively,tibial nerve SEP was abnormal in 58 sides,VEP in 14 sides and BAEP in 5 sides. The levels of vitamin B12 and plasma folate acid were lower than the normal levels in 21 and 7 cases respectivley. There was no obvious correlation between course of diseases and severity of nervous system lesion(pearson=0.036,P=0.84). Hematocrit was correlated with the severity of nervous system lesion (pearson=0.395,P=0.023). CONCLUSION:The clinical diagnosis of SCD depends on all laboratory indexes.Neuroelectrophysiological examination is valuable in diagnosing the lesion location of SCD and assessing the disease changes before and after therapy.
出处
《中国临床康复》
CSCD
2004年第28期6087-6089,共3页
Chinese Journal of Clinical Rehabilitation
