CAJ | 학술논문

目的：观察脑囊尾蚴病患者抗囊尾蚴治疗前后脑功能和病理形态学改变。方法对412例脑囊尾蚴病患者抗囊尾蚴治疗前后的脑电图和影像学资料进行回顾性分析。结果412例脑囊尾蚴病患者中，脑电图检查示轻、中、重度异常分别占40.53%、45.63%、13.84%；脑电波主要表现为弥漫性慢波和局限性慢波活动，或在异常背景上有少量散在或阵发性棘、尖波或棘-尖慢综合波。脑CT、MRI检查示单发小囊型占23.54%，多发小囊型占44.42%，脑炎型占13.59%，大、小囊并存型占4.85%，钙化型占2.18%，混合型占11.41%。脑囊尾蚴病患者经过3个疗程抗囊尾蚴治疗后复查，脑电图恢复正常和明显好转分别占79.85%和20.15%；CT、MRI检查发现77.18%的患者病灶全部吸收，20.63%的患者大部分病灶吸收，2.18%的患者病灶无变化，均为钙化型。脑内囊尾蚴感染处于急性期的单发和多发小囊型、脑炎型和大、小囊并存型抗囊尾蚴治疗效果好，混合型抗囊尾蚴治疗效果较差，处于钙化期的脑囊尾蚴病患者仅需进行对症治疗。结论脑囊尾蚴病患者脑电图表现为轻度至重度异常，脑CT、MRI检查以多发小囊型为主。经抗囊尾蚴治疗后，多数患者脑电图逐渐恢复正常，病灶全部吸收，但部分患者会留有少量钙化灶。
목적：관찰뇌낭미유병환자항낭미유치료전후뇌공능화병리형태학개변。방법대412례뇌낭미유병환자항낭미유치료전후적뇌전도화영상학자료진행회고성분석。결과412례뇌낭미유병환자중，뇌전도검사시경、중、중도이상분별점40.53%、45.63%、13.84%；뇌전파주요표현위미만성만파화국한성만파활동，혹재이상배경상유소량산재혹진발성극、첨파혹극-첨만종합파。뇌CT、MRI검사시단발소낭형점23.54%，다발소낭형점44.42%，뇌염형점13.59%，대、소낭병존형점4.85%，개화형점2.18%，혼합형점11.41%。뇌낭미유병환자경과3개료정항낭미유치료후복사，뇌전도회복정상화명현호전분별점79.85%화20.15%；CT、MRI검사발현77.18%적환자병조전부흡수，20.63%적환자대부분병조흡수，2.18%적환자병조무변화，균위개화형。뇌내낭미유감염처우급성기적단발화다발소낭형、뇌염형화대、소낭병존형항낭미유치료효과호，혼합형항낭미유치료효과교차，처우개화기적뇌낭미유병환자부수진행대증치료。결론뇌낭미유병환자뇌전도표현위경도지중도이상，뇌CT、MRI검사이다발소낭형위주。경항낭미유치료후，다수환자뇌전도축점회복정상，병조전부흡수，단부분환자회류유소량개화조。
Objective To study the changes of cerebral function and pathological morphology before and after the antiparasit-ic treatment with albendazole and praziquantel in patients with cerebral cysticercosis. Methods The data of EEG and neuroimag-ing of 412 patients with cerebral cysticercosis were retrospectively analyzed. Results Before the treatment,the mild abnormali-ty,moderate abnormality,and severe abnormality were observed in 40.53%,45.63% and 13.84% of the patients respectively, which mainly showed the diffuse or focal irregular slow waves,or epileptiform discharges found in the abnormal brain waves. CT/MRI manifestation could be divided into six types,including single sacculus type(23.59%),multiple sacculus type(44.42%), encephalitis type(13.59%),coexistence of macrocyst and sacculus type(4.85%),calcification type(2.18%),and mixed type (11.41%). After 3 courses of the treatment,the normal and improved EEGs were observed in 79.85%and 20.15%,respectively. CT/MRI showed the foci being all absorbed(77.18%),being most absorbed(20.63%),and being no changes(20.18%)which were calcified focus. When cerebral cysticercosis were in acute stage(the single and multiple sacculus type,encephalitis type, and macrocyst and sacculus coexistence type),the therapeutic effect was good;while in the mixed type,the therapeutic effect was relatively poor. If cysticercosis were in the calcification stage,the patients only needed the heteropathy. Conclusions In the pa-tients with cerebral cysticercosis,EEGs show the mild to severe abnormalities,and CT/MRI mainly shows the multiple sacculus type. After the treatment,the abnormal EEGs are gradually recovered and the low density foci can be all absorbed,but some calci-fied focus still exist in some patients.