CAJ | 학술논문

【目的】探讨非酮症高血糖合并舞蹈症的临床特点、M RI表现、治疗、预后及可能的发病机制。【方法】回顾性分析本院神经内科收治的1例及2003年10月至2013年12月43例通过检索中国期刊全文数据库、中国科技期刊万方数据库文献报道的非酮症性高血糖合并偏侧舞蹈症患者的临床资料。【结果】本研究共纳入44例病例，舞蹈症发病时的平均血糖水平为22．01 mmol／L ，34例患者为偏侧舞蹈症，10例患者双侧舞蹈症（头磁共振显示双侧基底节病变）。M RI显示全部患者壳核均受累，其中单纯壳核病变17例，伴有基底节其他部位病变27例，其中尾状核受累22例，苍白球受累5例，M RI表现为T1加权高信号。经过降低血糖并联合应用镇静剂等治疗，34例患者恢复正常，8例临床症状好转，2例患者药物治疗无效。【结论】非酮症高血糖合并舞蹈症是一种多发于老年人的良性疾病，女性患者更容易发病，头颅M RI的 T1加权高信号病变具有可逆性，并与临床舞蹈症缓解相关。
【목적】탐토비동증고혈당합병무도증적림상특점、M RI표현、치료、예후급가능적발병궤제。【방법】회고성분석본원신경내과수치적1례급2003년10월지2013년12월43례통과검색중국기간전문수거고、중국과기기간만방수거고문헌보도적비동증성고혈당합병편측무도증환자적림상자료。【결과】본연구공납입44례병례，무도증발병시적평균혈당수평위22．01 mmol／L ，34례환자위편측무도증，10례환자쌍측무도증（두자공진현시쌍측기저절병변）。M RI현시전부환자각핵균수루，기중단순각핵병변17례，반유기저절기타부위병변27례，기중미상핵수루22례，창백구수루5례，M RI표현위T1가권고신호。경과강저혈당병연합응용진정제등치료，34례환자회복정상，8례림상증상호전，2례환자약물치료무효。【결론】비동증고혈당합병무도증시일충다발우노년인적량성질병，녀성환자경용역발병，두로M RI적 T1가권고신호병변구유가역성，병여림상무도증완해상관。
[Objective] To explore clinical features and magnetic resonance image(MRI) manifestations of Chorea with non‐kenotic hyperglycemia .[Methods]Clinical data of one inpatient in our hospital and 43 cases of hemichorea with non‐kenotic hyperglycemia reported in the literatures were analyzed retrospectively .[Re‐sults] This study included 44 cases .The mean blood glucose level at onset of Chorea was 22 .01mmol/L .A‐mong all patients ,34 patients were hemichorea and 10 patients were bilateral Chorea(head MRI showed bilat‐eral basal ganglia lesions) .All putamen of patients were involved in MRI .There were 17 cases of simple puta‐men lesions and 27 cases combined with other parts of basal ganglia lesions including caudate nucleus involved in 22 cases and globus pallidus involved in 5 cases .Lesions were high signal intensity on T1‐weighted brain MRI .After controlling blood glucose combined with sedative treatment ,34 patients returned to normal ,and 9 patients had the improvement of clinical symptoms ,and 2 patients were invalid to medical therapy .[Conclu‐sion] Chorea combined with non‐kenotic hyperglycemia is a benign disorder affecting the elderly .It affects women much more frequently .The high signal intensity basal ganglia lesion on T1‐weighted brain MRI study is reversible and correlated with clinical improvement of chorea .