【摘要】：目的總結(jié)和分析成人乙腦的臨床表現(xiàn)、腦脊液及顱腦影像學(xué)特點(diǎn)。方法對(duì)山東大學(xué)齊魯醫(yī)院神經(jīng)內(nèi)科2013年8月到2013年9月間收治的36例成人乙腦患者進(jìn)行回顧性分析。結(jié)果乙腦患者主要表現(xiàn)為高熱(100%)、意識(shí)及認(rèn)知障礙、頭痛、惡心、嘔吐(86.1%)、腦膜刺激征(80.6%),帕金森樣癥狀(30.6%)和癲癇(27.8%)也較常見。血清和腦脊液乙腦Ig M抗體陽性。顱壓增高13例(54.2%),22例腦脊液細(xì)胞學(xué)檢測(cè)出現(xiàn)異常細(xì)胞反應(yīng),16例(72.7%)混合細(xì)胞反應(yīng),6例(27.3%)淋巴細(xì)胞反應(yīng)。17例(70.8%)蛋白升高,21例(87.5%)Ig G、19例(79.2%)Ig A、23例(95.8%)Ig M升高。22例(61.1%)行顱腦M RI,17例(47.2%)行顱腦CT。累及丘腦13例(59.1%),累及中腦4例(18.2%)、基底節(jié)3例(13.6%)、海馬3例(13.6%)和其他腦葉5例(22.7%),4例(18.2%)未見異常。結(jié)論流行性乙型腦炎的臨床表現(xiàn)為急性腦炎綜合征,可合并錐體外系癥狀;腦脊液中性粒細(xì)胞比例明顯增加,混合細(xì)胞反應(yīng)持續(xù)時(shí)間長(zhǎng);丘腦損害是最常見的影像學(xué)改變。
[Abstract]:Objective to summarize and analyze the clinical manifestations, cerebrospinal fluid (CSF) and craniocerebral imaging features of adult Japanese encephalitis (je). Methods 36 adult patients with encephalitis B were retrospectively analyzed from August 2013 to September 2013 in Department of Neurology, Qilu Hospital, Shandong University. Results High fever (100%), consciousness and cognitive impairment, headache, nausea and vomiting (86.1%), meningeal stimulation (80.6%), Parkinson's like symptoms (30.6%) and epilepsy (27.8%) were the main manifestations of encephalitis B. IgM antibody was positive in serum and cerebrospinal fluid. 13 cases (54.2%) with intracranial hypertension and 22 cases with cerebrospinal fluid cytology showed abnormal cellular reaction. Mixed cell reaction was detected in 16 cases (72.7%), lymphocyte reaction in 6 cases (27.3%), protein elevation in 21 cases (87.5%), IgA in 19 cases (79.2%), IgA in 23 cases (95.8%), elevation in) Ig M in 22 cases (61.1%), craniocerebral CT was performed in 17 cases (47.2%). There were 13 cases (59.1%) involved in thalamus, 4 cases (18.2%) in mesencephalon, 3 cases (13.6%) in basal ganglia, 3 cases (13.6%) in hippocampus and 5 cases (22.7%) in other lobes. Conclusion the clinical manifestation of epidemic encephalitis B is acute encephalitis syndrome, which can be combined with extrapyramidal symptoms, the proportion of neutrophils in cerebrospinal fluid is obviously increased and the reaction time of mixed cells is long. Thalamic lesion is the most common imaging change.
【作者單位】： 山東大學(xué)齊魯醫(yī)院神經(jīng)內(nèi)科(青島);山東大學(xué)齊魯醫(yī)院神經(jīng)內(nèi)科;
【分類號(hào)】：R512.32

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