摘要
目的探讨过敏性紫癜（HSP）合并中枢神经系统损害患儿的临床表现、辅助检查及治疗转归。方法回顾性分析2007年7月至2012年11月在首都医科大学附属北京儿童医院住院的HSP合并中枢神经系统损害患儿的临床资料，对其临床表现、辅助检查及治疗转归等进行归纳和分析。结果HSP患儿3512例，合并中枢神经系统损害18例，主要神经系统症状有抽搐、头痛、意识障碍和性格改变等。行脑脊液寡克隆区带检查6例，阳性4例；行脑电图检查13例，异常7例；行头颅cT检查10例，异常5例；行头颅MRI检查13例，异常9例。经对症、激素及静脉注射丙种球蛋白等治疗后18例患儿神经系统症状消失，随访13例，神经系统症状未见反复。结论HSP合并中枢神经系统损害症状可不典型，轻重不一，预后较好，无脑出血等严重脑血管炎病例。脑脊液寡克隆区带、头颅MRI、CT、脑电图等对HSP合并中枢神经系统损害的早期诊断和评估有一定意义。
Objective To investigate the clinical manifestations,laboratory examinations,treatments and prog- nosis of Henoch-Schn6lein purpura （HSP） children with central nervous system （CNS） dysfunction. Methods All clinical data of HSP patients with CNS dysfunction admitted to Beijing Children＇s Hospital Affiliated to Capital Medical University,from Jul. 2007 to Nov. 2012 were reviewed. Their manifestations, laboratory examinations, treatments and prognosis were analyzed. Results There were 18 patients with CNS dysfunctions in all 3512 HSP patients,the major presentations include convulsions, headache, altered level of consciousness and personality changes, et al. Six patients were investigate oligoclonal bands test in cerebrospinal fluid（CSF） ,4 cases of their results were positive. Thirteen pa- tients did the electroencephalogram （EEG） examination, 7 cases were abnormal. Ten patients did the brain CT scan, 5 cases of their results were abnormal. Thirteen patients did brain MR1,9 cases were abnormal. After treatment, the CNS manifestations disappeared in all patients. Thirteen patients were follow-up, none of their CNS symptoms relapsed. Con- clusions The presentations of patients with CNS system in HSP could be not so typical, and the condition of the patient could be more or less severe,while most of the prognosis of the patients are good. CSF oligoclonal bands test, EEG, brain CT and MRI are beneficial to the diagnosis and evaluation of the HSP associated with CNS dysfunction.
出处
《中华实用儿科临床杂志》
CAS
CSCD
北大核心
2013年第23期1821-1824,共4页
Chinese Journal of Applied Clinical Pediatrics
关键词
过敏性紫癜
血管炎
中枢神经系统损害
儿童
Henoch-SchOnlein syndrome
Vasculitis
Central nervous system dysfunction
Child
