合并肺结核的长节段脊髓炎2例报告

发布时间：2018-03-11 14:38

本文选题：长节段横贯性脊髓炎　切入点：视神经脊髓炎谱系疾病　出处：《中风与神经疾病杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的探讨长节段横贯性脊髓炎(longitudinally extensive transverse myelitis,LETM)与结核杆菌感染的相关性。方法回顾性分析国内外的LETM与结核杆菌感染的相关性研究报道,就我院收治的2例合并肺结核(pulmonary tuberculosis,PTB)的LETM患者进行临床分析。结果 2例合并PTB的长节段脊髓炎患者,其中病例1,AQP4-Ab/NMO-IgG阳性,诊断为视神经脊髓炎谱系疾病(neuromyelitis optica spectrum disorders,NMOSDs),其EDSS最高达7.0分,给予激素联合抗结核治疗后,随访1 y后EDSS为0分,长节段脊髓病灶较治疗前显著吸收;病例2为AQP4-Ab/NMO-IgG阴性的LETM患者,其EDSS 4.5分,给予激素联合抗结核治疗后,3 m随访病情明显改善,EDSS为0分,长节段脊髓病灶较治疗前显著吸收。结论本文经验性抗结核合并激素抑制免疫反应,对此类患者具有良好的治疗作用。关于结核感染与长节段脊髓炎之间的关系,仍需要进一步研究。
[Abstract]:Objective to investigate the relationship between longitudally extensive transverse infection (LETM) and Mycobacterium tuberculosis infection. Methods the correlation between LETM and Mycobacterium tuberculosis infection was analyzed retrospectively. A clinical analysis of 2 cases of LETM patients with pulmonary tuberculosis tuberculosis (PTB) was carried out in our hospital. Results two patients with long segment myelitis complicated with PTB were found to be positive for AQP4-Ab-NMO-IgG, and optica myelitis optica spectrum disordersNMOSDswere diagnosed as pedigree diseases of optic nerve myelitis, the highest EDSS score was 7.0 minutes. After being treated with hormone combined with anti-tuberculosis, the EDSS score was 0 and the long segment spinal cord lesion was significantly absorbed after 1 y follow-up. Case 2 was a AQP4-Ab/NMO-IgG negative LETM patient with a EDSS 4.5 score. After 3 m follow up, EDSS was significantly improved and long segment spinal cord lesions were significantly absorbed. Conclusion empirical antituberculous combined hormone immunosuppressive response was found in this study. [WT5HZ] [WT5 "HZ] [WT5" BZ] [WT5 "BZ] [WT5" HZ]. The relationship between tuberculosis infection and long segment myelitis needs further study.
【作者单位】：吉林大学白求恩第一医院神经内科和神经科学中心;
【分类号】：R521;R744.3

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