CAJ | 학술논문

目的探讨老年人低血糖脑病的临床及神经影像学特点.方法对36例低血糖伴神经系统表现的患者进行病史回顾、临床分析及颅脑CT和MRI检查.结果 36例低血糖患者11例发现颅脑MRI典型的双侧尾状核和豆状核对称性异常信号,而脑CT相应部位未见明显异常,病前27例有感染、发热等诱因,临床表现多种多样.低血糖脑病的发生以老年糖尿病患者口服或注射降糖药者居多.随访6个月,神经影像学无明显好转.结论低血糖脑病临床表现多不典型,对意识障碍的患者,要注意低血糖反应.颅脑CT对低血糖脑病的诊断价值不大,颅脑MRI对重症患者的诊断具有重要价值.特征性的磁共振表现预示着病情危重,且预后不良.
목적 탐토노년인저혈당뇌병적림상급신경영상학특점.방법 대36례저혈당반신경계통표현적환자진행병사회고、림상분석급로뇌CT화MRI검사.결과 36례저혈당환자11례발현로뇌MRI전형적쌍측미상핵화두상핵대칭성이상신호,이뇌CT상응부위미견명현이상,병전27례유감염、발열등유인,림상표현다충다양.저혈당뇌병적발생이노년당뇨병환자구복혹주사강당약자거다.수방6개월,신경영상학무명현호전.결론 저혈당뇌병림상표현다불전형,대의식장애적환자,요주의저혈당반응.로뇌CT대저혈당뇌병적진단개치불대,로뇌MRI대중증환자적진단구유중요개치.특정성적자공진표현예시착병정위중,차예후불량.
Objective To investigate the clinical and neuroimaging features of hypoglycemia encephalopathy in the elderly. Methods The history and clinical features of 36 patients who had undergone brain CT and MRI were analyzed retrospectively. Results Twenty-seven patients had infections and fevers as a trigger, presenting all kinds of symptoms. Eleven cases were found to have abnormal signals in bilateral caudate nucleus and lenticular nucleus in MRL But CT examination showed no new lesions in corresponding position. Hypoglycemia encephalopathy were commanly found in the elderly who had diabetes mellitus and treated with drugs. After being followed up for 6 months, their neuroimaging did not change. Conclusions Because the patients often present unconsciousness and weakness with a sudden onset, hypoglycemia is easily mistaken for other disorders, especially in the elderly. For those with consciousness, we should pay more attations to hypoglycemia. Brain CT has no value of diagnosing hypoglycemia encephalopathy, while MRI plays an impotant role in diagnosing the disease. The characteristic MRI features predicts a bad prognosis.