脊髓亚急性联合变性辅助检查的研究进展
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摘要
脊髓亚急性联合变性(SCD)是神经科较常见疾病,但因其发病率相对较低,一直以来未受到临床医生的足够重视。针对临床中疑似SCD病人,借助相关辅助检查做出早期诊断,使病人得到更为及时有效的治疗,进而改善预后显得尤为重要。本研究主要从实验室检测、磁共振成像、神经电生理三个方面对SCD做一综述,旨在提高临床医生对该病的认识及诊疗水平。
Subacute combined degeneration(SCD) of spinal cord is a relatively common disease of Neurology. However,it had not been paid enough attention to SCD by the clinicians because of the lower incidence rate. For suspected SCD patients,early diagnosis is made with the aid of relevant auxiliary examination so that the patients receive more timely and effective treatment. It is very important to improve the prognosis. This paper focuses on laboratory detection,magnetic resonance imaging,electro-neurophysiology,three aspects of SCD,to improve the knowledge and the level of diagnosis and treatment.
Subacute combined degeneration(SCD) of spinal cord is a relatively common disease of Neurology. However,it had not been paid enough attention to SCD by the clinicians because of the lower incidence rate. For suspected SCD patients,early diagnosis is made with the aid of relevant auxiliary examination so that the patients receive more timely and effective treatment. It is very important to improve the prognosis. This paper focuses on laboratory detection,magnetic resonance imaging,electro-neurophysiology,three aspects of SCD,to improve the knowledge and the level of diagnosis and treatment.
引文
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[9]吕颖坚,黄俊明.维生素B12的研究进展[J].中国食品卫生杂志,2012,24(4):394-399.
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[12] BRIANI C,DALLA TC,CITTON V,et al. Cobalamin deficiency:clinical picture and radiological findings[J]. Nutrients,2013,5(11):4521-4539.
[13] DIVATE PG,PATANWALA R. Neurological manifestations of B12deficiency with emphasis on its aetiology[J]. J Assoc Physicians India,2014,62(5):400-405.
[14]宋旸,王锁彬,陆慧.脊髓亚急性联合变性与内因子抗体[J].神经疾病与精神卫生,2015,(3):273-275.
[15]郭军红,侯玉立,吴士文,等.对激素治疗敏感的脊髓亚急性联合变性一例[J].中国神经免疫学和神经病学杂志,2008,15(5):390-391.
[16]张瑞云,武力勇,冯雪岩,等.内因子抗体和(或)抗胃壁细胞抗体阳性的脊髓亚急性联合变性8例分析[J].北京医学,2016,38(1):5-8.
[17]张洁,邢岩,崔丽英.肌萎缩侧索硬化患者的脑脊液蛋白及髓鞘碱性蛋白相关研究[J].中国神经免疫学和神经病学杂志,2016,23(4):248-250.
[18] LEE WJ,HSU HY,WANG PY. Reversible myelopathy on magnetic resonance imaging due to cobalamin deficiency[J]. J Chin Med Assoc,2008,71(7):368-372.
[19] ARBOUR N,HOLZ A,SIPE JC,et al. A new approach for evaluating antigen-specific T cell responses to myelin antigens during the course of multiple sclerosis[J]. J Neuroimmunol,2003,137(1/2):197-209
[20]周晋,孟然,李国忠,等.亚急性联合变性与维生素B12缺乏和巨幼红细胞贫血的研究[J].中华内科杂志,2004,43(2):90-93.
[21]路浩,秦维伟,吴琼,等.脊髓亚急性联合变性的MRI表现及诊断价值[J].中国伤残医学,2013,21(8):93-94.
[22]陈峰,余永强.磁共振张量成像在脊髓型颈椎病中的应用进展[J].安徽医药,2015,19(8):1438-1441.
[23] KUMAR A,SINGH AK. Teaching NeuroImage:Inverted V sign in subacute combined degeneration of spinal cord[J]. Neurology,2009,72(1):e4. DOI:10. 1212/01. wnl. 0000338663. 59433. 9c.
[24] SUN HY,LEE JW,PARK KS,et al. Spine MR imaging features of subacute combined degeneration patients[J]. Eur Spine J,2014,23(5):1052-1058.
[25]武红玲,王松,李海军,等.脊髓亚急性联合变性MRI分析[J].中国保健营养,2013,5(5):663.
[26]刘润惠.脊髓亚急性联合变性的MRI诊断及鉴别诊断[J].医学美学美容(中旬刊),2015,1(1):100-100.
[27]邱志茹,刘洪波,王少平,等.神经电生理检查在脊髓亚急性联合变性中的诊断应用[J].中国实用神经疾病杂志,2013,16(9):6-8.
[28] KASTRUP O,TIMMAN D,DIENER HC. Isolated degeneration of the posterior column as a distinct entity—a clinical and electrophysiologic follow-up study[J]. Clin Neurol Neurosurg,2010,112(3):209-212.
[29]沈雪莉,张红雷.脊髓亚急性联合变性周围神经损害临床及神经电生理表现特点[J].中国老年学杂志,2011,31(12):2332-2333.
[30] MISRA UK,KALITA J. Comparison of clinical and electrodiagnostic features in B12 deficiency neurological syndromes with and without Antiparietal cell antibodies[J],Post-gIad Med J,2007,83(976):124-127.
[31]白新刚,郭鸿,郑重,等.接触性热痛诱发电位在临床中的应用[J].中国临床研究,2014,27(12):1539-1541,1544.
[32]靳梅,谢炳玓.接触性热痛诱发电位在亚急性联合变性诊断中的应用[J].中华神经科杂志,2010,43(4):277-281.
[33]李鹏鹏,赵斌,赵晓峰,等.脊髓亚急性联合变性临床研究进展[J].中华临床医师杂志(电子版),2016,10(1):121-123. DOI:10. 3877/cma. j. issn. 1674-0785. 2016. 01. 026.
[2]毕鸿雁,张芹,赵亚明,等.脊髓亚急性联合变性24例临床分析[J].中国神经免疫学和神经病学杂志,2014,21(4):254-256.
[3]曲方,李晓秋,朱益,等.亚急性联合变性的脊髓MRI特征[J].中国临床神经科学,2014,22(6):642-645.
[4] LI J,REN M,DONG A,et al. A retrospective study of 23 cases with subacute combined degeneration[J]. Int J Neurosci,2016,126(10):872-877.
[5] GURSOY AE,KOLUKISA M,BABACAN-YILDIZ G,et al. Subacute combined degeneration of the spinal cord due to different etiologies and improvement of MRI findings[J]. Case Rep Neurol Med,2013,2013:159649. DOI:10. 1155/2013/159649.
[6] JAIN KK,MALHOTRA HS,GARG RK,et al. Prevalence of MR imaging abnormalities in vitamin B12 deficiency patients presenting with clinical features of subacute combined degeneration of the spinal cord[J]. J Neurol Sci,2014,342(1/2):162-166.
[7] PUGLIESE RS,SLAGLE EJ,OETTINGER GR,et al. Subacute combined degeneration of the spinal cord in a patient abusing nitrous oxide and self-medicating with cyanocobalamin[J]. Am J Health Syst Pharm,2015,72(11):952-957.
[8]王志晔,谈友芬.脊髓亚急性联合变性临床分析[J].中国医药,2011,6(2):161-162.
[9]吕颖坚,黄俊明.维生素B12的研究进展[J].中国食品卫生杂志,2012,24(4):394-399.
[10] HVAS AM,NEXO E. Diagnosis and treatment of vitamin B12 deficiency-an update[J]. Haematologica,2006,91(11):1506-1512.
[11] NEXO E,HOFFMANN-LUCKE E. Holotranscobalamin,a marker of vitamin B-12 status:analytical aspects and clinical utility[J].Am J Clin Nutr,2011,94(1):359S-365S.
[12] BRIANI C,DALLA TC,CITTON V,et al. Cobalamin deficiency:clinical picture and radiological findings[J]. Nutrients,2013,5(11):4521-4539.
[13] DIVATE PG,PATANWALA R. Neurological manifestations of B12deficiency with emphasis on its aetiology[J]. J Assoc Physicians India,2014,62(5):400-405.
[14]宋旸,王锁彬,陆慧.脊髓亚急性联合变性与内因子抗体[J].神经疾病与精神卫生,2015,(3):273-275.
[15]郭军红,侯玉立,吴士文,等.对激素治疗敏感的脊髓亚急性联合变性一例[J].中国神经免疫学和神经病学杂志,2008,15(5):390-391.
[16]张瑞云,武力勇,冯雪岩,等.内因子抗体和(或)抗胃壁细胞抗体阳性的脊髓亚急性联合变性8例分析[J].北京医学,2016,38(1):5-8.
[17]张洁,邢岩,崔丽英.肌萎缩侧索硬化患者的脑脊液蛋白及髓鞘碱性蛋白相关研究[J].中国神经免疫学和神经病学杂志,2016,23(4):248-250.
[18] LEE WJ,HSU HY,WANG PY. Reversible myelopathy on magnetic resonance imaging due to cobalamin deficiency[J]. J Chin Med Assoc,2008,71(7):368-372.
[19] ARBOUR N,HOLZ A,SIPE JC,et al. A new approach for evaluating antigen-specific T cell responses to myelin antigens during the course of multiple sclerosis[J]. J Neuroimmunol,2003,137(1/2):197-209
[20]周晋,孟然,李国忠,等.亚急性联合变性与维生素B12缺乏和巨幼红细胞贫血的研究[J].中华内科杂志,2004,43(2):90-93.
[21]路浩,秦维伟,吴琼,等.脊髓亚急性联合变性的MRI表现及诊断价值[J].中国伤残医学,2013,21(8):93-94.
[22]陈峰,余永强.磁共振张量成像在脊髓型颈椎病中的应用进展[J].安徽医药,2015,19(8):1438-1441.
[23] KUMAR A,SINGH AK. Teaching NeuroImage:Inverted V sign in subacute combined degeneration of spinal cord[J]. Neurology,2009,72(1):e4. DOI:10. 1212/01. wnl. 0000338663. 59433. 9c.
[24] SUN HY,LEE JW,PARK KS,et al. Spine MR imaging features of subacute combined degeneration patients[J]. Eur Spine J,2014,23(5):1052-1058.
[25]武红玲,王松,李海军,等.脊髓亚急性联合变性MRI分析[J].中国保健营养,2013,5(5):663.
[26]刘润惠.脊髓亚急性联合变性的MRI诊断及鉴别诊断[J].医学美学美容(中旬刊),2015,1(1):100-100.
[27]邱志茹,刘洪波,王少平,等.神经电生理检查在脊髓亚急性联合变性中的诊断应用[J].中国实用神经疾病杂志,2013,16(9):6-8.
[28] KASTRUP O,TIMMAN D,DIENER HC. Isolated degeneration of the posterior column as a distinct entity—a clinical and electrophysiologic follow-up study[J]. Clin Neurol Neurosurg,2010,112(3):209-212.
[29]沈雪莉,张红雷.脊髓亚急性联合变性周围神经损害临床及神经电生理表现特点[J].中国老年学杂志,2011,31(12):2332-2333.
[30] MISRA UK,KALITA J. Comparison of clinical and electrodiagnostic features in B12 deficiency neurological syndromes with and without Antiparietal cell antibodies[J],Post-gIad Med J,2007,83(976):124-127.
[31]白新刚,郭鸿,郑重,等.接触性热痛诱发电位在临床中的应用[J].中国临床研究,2014,27(12):1539-1541,1544.
[32]靳梅,谢炳玓.接触性热痛诱发电位在亚急性联合变性诊断中的应用[J].中华神经科杂志,2010,43(4):277-281.
[33]李鹏鹏,赵斌,赵晓峰,等.脊髓亚急性联合变性临床研究进展[J].中华临床医师杂志(电子版),2016,10(1):121-123. DOI:10. 3877/cma. j. issn. 1674-0785. 2016. 01. 026.