36例成人流行性乙型脑炎临床分析和影像学特点
发布时间：2018-08-03 09:01
【摘要】：目的总结和分析成人乙脑的临床表现、脑脊液及颅脑影像学特点。方法对山东大学齐鲁医院神经内科2013年8月到2013年9月间收治的36例成人乙脑患者进行回顾性分析。结果乙脑患者主要表现为高热(100%)、意识及认知障碍、头痛、恶心、呕吐(86.1%)、脑膜刺激征(80.6%),帕金森样症状(30.6%)和癫痫(27.8%)也较常见。血清和脑脊液乙脑Ig M抗体阳性。颅压增高13例(54.2%),22例脑脊液细胞学检测出现异常细胞反应,16例(72.7%)混合细胞反应,6例(27.3%)淋巴细胞反应。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%)行颅脑M RI,17例(47.2%)行颅脑CT。累及丘脑13例(59.1%),累及中脑4例(18.2%)、基底节3例(13.6%)、海马3例(13.6%)和其他脑叶5例(22.7%),4例(18.2%)未见异常。结论流行性乙型脑炎的临床表现为急性脑炎综合征,可合并锥体外系症状;脑脊液中性粒细胞比例明显增加,混合细胞反应持续时间长;丘脑损害是最常见的影像学改变。
[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.
【作者单位】： 山东大学齐鲁医院神经内科(青岛);山东大学齐鲁医院神经内科;
【分类号】：R512.32
本文编号：2161255
[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.
【作者单位】： 山东大学齐鲁医院神经内科(青岛);山东大学齐鲁医院神经内科;
【分类号】：R512.32
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