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临床常见脑病的临床及影像学特点分析 被引量:6

Clinical and imaging features of clinical common encephalopathies
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摘要 目的探讨临床常见的脑病,包括代谢、中毒及放射性脑病等临床常见脑病的临床及影像学表现特点。方法收集作者医院收治的临床常见脑病患者43例,其中中毒性脑病17例(包括装修苯中毒1例、鼠药氟乙酰胺中毒1例、化疗药物中毒5例、有机磷农药中毒4例、一氧化碳中毒5例、海洛因中毒1例)、放射性脑病5例及代谢性脑病21例(包括Wernick脑病2例、低血糖脑病4例、肝性脑病4例、尿毒症性脑病5例、桥本脑病3例、甲基丙二酸尿症1例、卟啉病1例、伴有囊肿及钙化的白质脑病1例),总结分析临床常见脑病的临床及影像学特点。结果 (1)临床表现:不同病因脑病患者多表现为不同程度的认知功能障碍、精神行为异常、言语含糊及计算力减退等,部分患者表现为肢体力弱或无力,少数患者表现为语音障碍、眼球固定、发作性肢体抽搐及腹痛等。(1)表现为认知功能障碍:包括不同程度的反应迟钝伴记忆力减退(脑病中苯中毒1例、有机磷农药中毒2例、化疗药物中毒5例、一氧化碳中毒2例、放射性脑病5例、尿毒症性脑病5例、桥本脑病3例),以及不同程度的意识障碍(有机磷农药中毒2例、一氧化碳中毒3例、低血糖脑病2例、肝性脑病4例);(2)精神行为异常(桥本脑病3例、甲基丙二酸尿症1例);(3)表现为言语含糊伴计算力减退(海洛因脑病1例);(4)部分患者表现为肢体力弱或无力,少数患者表现为语音障碍、眼球固定、发作性肢体抽搐及腹痛等,其中包括放射性脑病3例、低血糖脑病2例、甲基丙二酸尿症1例、卟啉病1例、伴有囊肿及钙化的白质脑病1例表现为肢体力弱,Wernick脑病2例表现为进行性声音嘶哑伴双下肢力弱及眼球固定,苯中毒及鼠药氟乙酰胺中毒各1例表现为发作性肢体抽搐,卟啉病1例表现为发作性腹痛、肢体无力伴言语不清。(2)影像学表现:影像学表现病变主要累及白质� Objective To research the clinical and imaging features of clinical common encephalopathies,including metabolic,toxic and radiation encephalopathies.Methods We gathered 43 cases of clinical common encephalopathy.17 cases of toxic encephalopathy including benzene(1 case),fluorine ethane(1 case),chemotherapeutic agents(5 case),organophosphorus(4 case),carbon monoxide(5 case),and heroinomania poisoning(1 case).21 cases of metabolic encephalopathy included Wernicke encephalopathy(2 case),hypoglycaemia(4 case),hepatic encephalopathy(4 case),uremia(5 case),Hashimoto encephalopathy(3 case),methyl malonic acid urine disease(1 case),porphyrin disease(1 case)and leukoencephalopathy brain calcifications and cysts(1 case).We researched clinical and imaging features of these clinical common encephalopathies.Results Decreased memory and response were present in benzene(1 case),organophosphorus(2 case),chemotherapeutic agents(5 case),and carbon monoxide(2 case)intoxication,as well as radiation encephalopathy(5 case),uremia(5 case),and Hashimoto encephalopathy(3 case).Seizure was present in benzene(1 case)and fluorine ethane(1 case)in toxication.Conscious distubance was present in organophosphorus(2 case),carbon monoxide(3 case),hypoglycaemia(2 case),hepatic encephalopathy(4 case).Limbs weakness was present in radiation encephalopathy(3 case),hypoglycaemia(2 case),methyl malonic acid urine disease(1 case),porphyrin disease(1 case)and leukoencephalopathy brain calcifications and cysts(1 case).Mental disorders were present in Hashimoto encephalopathy(3 case),methyl malonic acid urine disease(1 case).Blurred speech and decreased calculation were present in heroinomania poisoning(1 case).Hoarse voice,bilateral lower extremities weakness and eyeball fixed showed in Wernicke encephalopathy(2 case).Blurred speech,extremities weakness and paroxysmal abdominal pain showed in porphyrin disease(1
作者 俞英欣 戚晓昆 郑奎宏 YU Yingxin;QI Xiaokun;ZHENG Kuihong(Department of Radiology,Navy General Hospital,Beijing 100048,China)
出处 《中国神经免疫学和神经病学杂志》 CAS 北大核心 2018年第4期252-261,共10页 Chinese Journal of Neuroimmunology and Neurology
基金 国家自然科学基金青年科学基金项目(81300923) 首都临床特色应用研究与成果推广(Z16110000516187) 海军总医院创新培育基金(CXPY201421)
关键词 代谢性脑病 中毒性脑病 放射性脑病 影像学 磁共振波谱学 metabolic encephalopathy toxic encephalopathy radiation encephalopathy imaging
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