CAJ | 학술논문

目的探讨原发性干燥综合征的中枢神经系统损害的临床表现、MRI特点、治疗方法。方法回顾性分析漳州市福建医科大学附属漳州市医院确诊的8例原发性干燥综合征合并中枢神经系统损害的临床表现、MRI特点。结果临床可表现为延髓背外侧综合征、肢体无力、智能改变，可类似多发性硬化、视神经脊髓炎，视神经较经常累及；MRI检查示5例出现脊髓损害：病变部位以颈胸髓为主，颈髓2例，胸髓2例,1例同时累及颈髓和胸髓，病灶可大片状、散在斑片状，可轻度、明显强化或不强化,5例出现颅内损害：病变部位可见于延髓背外侧、丘脑、海马、中脑导水管、第四脑室旁、侧脑室旁，可表现为皮质下及脑室旁白质多发小缺血灶，可类似韦尼克脑病，l例出现颈动脉夹层,7例使用了激素后病情有一定改善。结论原发性干燥综合征中枢神经系统损害的症状、体征及影像学表现多种多样。
목적탐토원발성간조종합정적중추신경계통손해적림상표현、MRI특점、치료방법。 방법 회고성분석장주시복건의과대학부속장주시의원학진적8례원발성간조종합정합병중추신경계통손해적림상표현、MRI특점。 결과림상가표현위연수배외측종합정、지체무력、지능개변，가유사다발성경화、시신경척수염，시신경교경상루급；MRI검사시5례출현척수손해：병변부위이경흉수위주，경수2례，흉수2례,1례동시루급경수화흉수，병조가대편상、산재반편상，가경도、명현강화혹불강화,5례출현로내손해：병변부위가견우연수배외측、구뇌、해마、중뇌도수관、제사뇌실방、측뇌실방，가표현위피질하급뇌실방백질다발소결혈조，가유사위니극뇌병，l례출현경동맥협층,7례사용료격소후병정유일정개선。 결론원발성간조종합정중추신경계통손해적증상、체정급영상학표현다충다양。
Objective To investigate the clinical manifestations, MRI features and therapeutic methods of patients with central nervous system damage secondary to primary Sjogren syndrome.Methods The clinical features, MR1 manifestations and therapeutic method of 8 patients with central nervous system damage secondary to primary Sjogren syndrome, confirmed in our hospital, were retrospectively reviewed and analyzed. Results Wallenberg syndrome, limb weakness and mentality alteration appeared in these patients, some manifested as having multiple sclerosis and neuromyelitis optica, and optic nerve was frequently involved. MRI results indicated that 5 patients had lesion in the spinal cord, mainly located in the cervical and thoracic cords: 2 in the cervical cord, 2 in the thoracic cord, and 1 both in the cervical and thoracic cords; the lesions manifested as sheet lamellar, scattered plaques with mild/obvious enhancement or without enhancement; 5 patients had brain damage: lesious could be detected in the dorsolateral medulla oblongata, thalamus, hippocampus, aqueduct of midbrain,and sides of fourth ventricle and lateral ventricles, and these lesions could manifest as multiple minor ischemic focus white matter in the subcortex and cerebral ventricles, which might be similar to Wernicke encephalopathy; 1 patient appeared cervical artery dissection, and 7 patients got improvement after the treatment of hormone. Conclusion The clinical features and MRI manifestations of patients with central nervous system damage secondary to primary Sjogren syndrome are diverse.