中华行为医学与脑科学杂志
中華行為醫學與腦科學雜誌
중화행위의학여뇌과학잡지
CHINESE JOURNAL OF BEHAVIORAL MEDICINE AND BRAIN SCIENCE
2009年
8期
718-720
,共3页
王忠磊%史世俊%毛德华%张晓玉%夏如花
王忠磊%史世俊%毛德華%張曉玉%夏如花
왕충뢰%사세준%모덕화%장효옥%하여화
脑囊虫病%临床%影像学%免疫学%脑电图
腦囊蟲病%臨床%影像學%免疫學%腦電圖
뇌낭충병%림상%영상학%면역학%뇌전도
Cereberal cysticercosis%Clinical%Imaging%Immunology%EEG
目的 研究大囊型脑囊虫病患者抗囊治疗前后的临床、影像学、免疫学及脑电图改变.方法 对59例大囊型脑囊虫病患者的临床、影像学、免疫学和脑电图资料进行系统性回顾研究.结果 本组患者中有38.98%以癫痫发作为首发症状,45.76%表现为头痛、头晕、恶心伴有呕吐症状;脑CT或MRI主要特征为圆形或类圆形低密度灶病灶,直径大小为20～73 mm;血IHA、ELISA、CAg阳性率分别为91.53%、98.31%和88.14%;脑电图异常率为89.83%,主要表现为弥漫性慢波和局限性慢波活动.59例患者经3～4个疗程的抗囊治疗后,临床上有91.30%患者癫痫症状得到完全控制,88.89%患者头痛、头晕、恶心伴有呕吐者恢复正常,其他如肢体麻木、语言障碍等症状全部消失;复查脑CT或MRI有96.61%患者病灶全部吸收,3.39%患者转化为钙化点;56例观察了免疫学的动态变化,血IHA、ELISA、CAg阳性率分别为89.29%、96.42%和5.36%;51例复查了脑电图,恢复正常和明显好转的分别为78.43%和21.57%;患者抗囊治疗前后对比除IHA、ELISA结果无统计学意义外均差异有显著性(P<0.01);临床治愈率96.61%,显效率3.39%,总有效率100%.结论 大囊型脑囊虫病患者抗囊治疗后临床症状、异常脑功能和病理形态学改变可以逐渐恢复;影像学、免疫学及脑电图检查从不同方面对脑囊虫病的诊断、疗效考核具有重要的应用价值.
目的 研究大囊型腦囊蟲病患者抗囊治療前後的臨床、影像學、免疫學及腦電圖改變.方法 對59例大囊型腦囊蟲病患者的臨床、影像學、免疫學和腦電圖資料進行繫統性迴顧研究.結果 本組患者中有38.98%以癲癇髮作為首髮癥狀,45.76%錶現為頭痛、頭暈、噁心伴有嘔吐癥狀;腦CT或MRI主要特徵為圓形或類圓形低密度竈病竈,直徑大小為20～73 mm;血IHA、ELISA、CAg暘性率分彆為91.53%、98.31%和88.14%;腦電圖異常率為89.83%,主要錶現為瀰漫性慢波和跼限性慢波活動.59例患者經3～4箇療程的抗囊治療後,臨床上有91.30%患者癲癇癥狀得到完全控製,88.89%患者頭痛、頭暈、噁心伴有嘔吐者恢複正常,其他如肢體痳木、語言障礙等癥狀全部消失;複查腦CT或MRI有96.61%患者病竈全部吸收,3.39%患者轉化為鈣化點;56例觀察瞭免疫學的動態變化,血IHA、ELISA、CAg暘性率分彆為89.29%、96.42%和5.36%;51例複查瞭腦電圖,恢複正常和明顯好轉的分彆為78.43%和21.57%;患者抗囊治療前後對比除IHA、ELISA結果無統計學意義外均差異有顯著性(P<0.01);臨床治愈率96.61%,顯效率3.39%,總有效率100%.結論 大囊型腦囊蟲病患者抗囊治療後臨床癥狀、異常腦功能和病理形態學改變可以逐漸恢複;影像學、免疫學及腦電圖檢查從不同方麵對腦囊蟲病的診斷、療效攷覈具有重要的應用價值.
목적 연구대낭형뇌낭충병환자항낭치료전후적림상、영상학、면역학급뇌전도개변.방법 대59례대낭형뇌낭충병환자적림상、영상학、면역학화뇌전도자료진행계통성회고연구.결과 본조환자중유38.98%이전간발작위수발증상,45.76%표현위두통、두훈、악심반유구토증상;뇌CT혹MRI주요특정위원형혹류원형저밀도조병조,직경대소위20～73 mm;혈IHA、ELISA、CAg양성솔분별위91.53%、98.31%화88.14%;뇌전도이상솔위89.83%,주요표현위미만성만파화국한성만파활동.59례환자경3～4개료정적항낭치료후,림상상유91.30%환자전간증상득도완전공제,88.89%환자두통、두훈、악심반유구토자회복정상,기타여지체마목、어언장애등증상전부소실;복사뇌CT혹MRI유96.61%환자병조전부흡수,3.39%환자전화위개화점;56례관찰료면역학적동태변화,혈IHA、ELISA、CAg양성솔분별위89.29%、96.42%화5.36%;51례복사료뇌전도,회복정상화명현호전적분별위78.43%화21.57%;환자항낭치료전후대비제IHA、ELISA결과무통계학의의외균차이유현저성(P<0.01);림상치유솔96.61%,현효솔3.39%,총유효솔100%.결론 대낭형뇌낭충병환자항낭치료후림상증상、이상뇌공능화병리형태학개변가이축점회복;영상학、면역학급뇌전도검사종불동방면대뇌낭충병적진단、료효고핵구유중요적응용개치.
Objective To observe the changes of clinical,imaging,immunology and EEG pro-post-treat-ment with albendazole praziquantel in patients with large cystic cereberal cysticercosis. Methods The data of clin-ical features,imaging,immunology and EEG of 59 patients with large cystic cereberal cysticercosis were retrospec-tively analyzed. Results Among these patients, the rate of epileptic seizures was 38.98% and headache, dizzi-ness, nausea and vomiting were 45.76% ;CT or MRI showed that shapes of the low density loci were round or para round,its diameter was 20 -73mm. The positive rates of serum of patients by IHA, ELISA and CAg were 91.53 % , 98.31% and 88.14% respectively. The abnormal rate of EEG was 89.83% in patients,which mainly showed the diffuse and localized slow waves. After 3～4 courses of treatment,91.30% of epileptic seizure was controlled, 88.89% of the symptoms of headache, dizziness, nausea and vomiting were recovered, and the symptoms of limb numbness,language barriers also disappeared;CT or MRI showed that the low density foci were all absorbed in 96.61% and calcified in 3.39% of the patients. The positive rates of blood IHA ,ELISA and CAg were 89.29%, 96.42% and 5.36% respectively. The normal and improved EEGS were observed in 78.43% and 21.57%. There were significant differences in cure rate, effective rate and total effective rate before and after treatment, being 96.61% and 3.39% respectively, excluded IHA, ELISA (P<0.01). Conclusion Clinical symptoms, cerebral function and pathological changes are gradually recovered in patients after treatment. Imaging, immunology and EEG check are valuable for diagnosis and the treatment of patients with large cystic cereberal cysticercosis.
