本文選題：多發(fā)性硬化 + 脫髓鞘疾病��； 參考：《山東醫(yī)藥》2016年43期

【摘要】：目的探討老年人多發(fā)性硬化(MS)的臨床特點。方法患有MS的老年患者25例,對其病因、臨床表現(xiàn)、輔助檢查結(jié)果、治療及預(yù)后結(jié)果等作回顧性分析。結(jié)果 25例患者中,男12例、女13例,年齡60~75歲。既往曾患干燥綜合征2例、類風濕關(guān)節(jié)炎1例。發(fā)病前有誘因者4例,亞急性起病21例,復(fù)發(fā)緩解型22例。神經(jīng)系統(tǒng)癥狀為肢體無力14例、感覺障礙10例、大小便障礙8例、視力障礙8例、智能障礙7例。25例行血清抗水通道蛋白抗體-4檢查均陰性。MRI檢查示大腦半球病變22例、腦干病變9例、頸髓病變7例、胸髓病變5例。23例誘發(fā)電位異常。急性期均予以糖皮質(zhì)激素治療,臨床痊愈4例、好轉(zhuǎn)16例。結(jié)論老年人MS以亞急性起病為主,多為復(fù)發(fā)緩解型;老年人MS常見癥狀是肢體無力、感覺障礙、視力障礙、二便障礙;腦脊液、MRI、神經(jīng)電生理檢查有助于本病的診斷;糖皮質(zhì)激素在老年人MS治療中發(fā)揮一定作用。
[Abstract]:Objective to investigate the clinical features of multiple sclerosis (MS) in the elderly. Methods 25 elderly patients with MS were retrospectively analyzed for their etiology, clinical manifestations, auxiliary examination results, treatment and prognosis. Results among the 25 patients, 12 were male and 13 female, aged 60 ~ 75 years. There were 2 cases of Sjogren's syndrome and 1 case of rheumatoid arthritis. There were 4 cases with inducement before onset, 21 cases with subacute onset and 22 cases with relapse and remission. There were 14 cases of limb weakness, 10 cases of sensory disturbance, 8 cases of defecation and urination, 8 cases of visual impairment, 7 cases of intellectual disorder and 25 cases of mental retardation. All of them were negative in serum anti-aquaporin antibody -4. MRI examination showed cerebral hemispheric lesion in 22 cases. Brainstem lesions 9 cases, cervical spinal cord lesions 7 cases, thoracic myelopathy 5 cases. 23 cases abnormal evoked potentials. All of them were treated with glucocorticoid in acute stage, 4 cases were cured and 16 cases improved. Conclusion the main symptoms of MS in the elderly are subacute onset, most of which are relapse and remission, the common symptoms of MS in the elderly are limb weakness, sensory disturbance, visual impairment and defecation disorder, MRI and electrophysiological examination of cerebrospinal fluid are helpful for the diagnosis of this disease. Glucocorticoids play a role in the treatment of elderly MS.
【作者單位】： 贛南醫(yī)學(xué)院第一附屬醫(yī)院;
【分類號】：R744.51

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