临床误诊误治
臨床誤診誤治
림상오진오치
CLINICAL MISDIAGNOSIS & MISTHERAPY
2015年
4期
88-90
,共3页
房效莉%曹幸毅%宋金莲%梅倩倩%吴士文
房效莉%曹倖毅%宋金蓮%梅倩倩%吳士文
방효리%조행의%송금련%매천천%오사문
肌萎缩侧索硬化%并发症%认知功能障碍%误诊
肌萎縮側索硬化%併髮癥%認知功能障礙%誤診
기위축측색경화%병발증%인지공능장애%오진
Amyotrophic lateral sclerosis%Complication%Cognitive dysfunction%Misdiagnosis
目的:了解散发性肌萎缩侧索硬化( sporadic amyotrophic lateral sclerosis, sALS)的临床特点,以提高临床诊断率。方法回顾性分析2009年6月—2014年6月武警总医院收治的39例sALS的临床资料。结果本组发病平均年龄(54.7±10.7)岁,男性多见,病程高峰在24个月左右。发病人群主要为既往体健人群,临床表现主要为肌无力、肌肉萎缩、肌束震颤、言语不清和饮水呛咳,5例(12.8%)伴随认知功能障碍,颈髓受累最多。结论 sALS以中年发病为主,男性多见,sALS伴认知功能障碍可能与阿尔茨海默病和额颞叶痴呆等其他神经系统变性病存在某种联系;详细问诊,仔细查体,及时行肌电图检查并注意鉴别诊断,有助于诊断。
目的:瞭解散髮性肌萎縮側索硬化( sporadic amyotrophic lateral sclerosis, sALS)的臨床特點,以提高臨床診斷率。方法迴顧性分析2009年6月—2014年6月武警總醫院收治的39例sALS的臨床資料。結果本組髮病平均年齡(54.7±10.7)歲,男性多見,病程高峰在24箇月左右。髮病人群主要為既往體健人群,臨床錶現主要為肌無力、肌肉萎縮、肌束震顫、言語不清和飲水嗆咳,5例(12.8%)伴隨認知功能障礙,頸髓受纍最多。結論 sALS以中年髮病為主,男性多見,sALS伴認知功能障礙可能與阿爾茨海默病和額顳葉癡呆等其他神經繫統變性病存在某種聯繫;詳細問診,仔細查體,及時行肌電圖檢查併註意鑒彆診斷,有助于診斷。
목적:료해산발성기위축측색경화( sporadic amyotrophic lateral sclerosis, sALS)적림상특점,이제고림상진단솔。방법회고성분석2009년6월—2014년6월무경총의원수치적39례sALS적림상자료。결과본조발병평균년령(54.7±10.7)세,남성다견,병정고봉재24개월좌우。발병인군주요위기왕체건인군,림상표현주요위기무력、기육위축、기속진전、언어불청화음수창해,5례(12.8%)반수인지공능장애,경수수루최다。결론 sALS이중년발병위주,남성다견,sALS반인지공능장애가능여아이자해묵병화액섭협치태등기타신경계통변성병존재모충련계;상세문진,자세사체,급시행기전도검사병주의감별진단,유조우진단。
Objective To determine the clinical characteristics of sporadic amyotrophic lateral sclerosis (sALS), to improve the accuracy of diagnosis. Methods We reviewed 39 cases visiting the General Hospital of Chinese People's Armed Po-lice force during June 2009 and June 2014. Results The average morbidity age was (54. 7 ± 10. 7)years-old. They were mostly male patients and the peak of the course was at the 24th month. The risk of paroxysm was greatly increased in individuals who were factory workers and farmers and who used to be in good health. The main clinical manifestations included muscle weakness, muscle atrophy, fasciculations, slurred speech, drinking cough and cognitive dysfunction. About 12. 8% of sALS had cognitive impairment. The cervical cord was supposed to be the predilection site. Conclusion sALS is a middle-aged, male predominant disease. sALS accompanied with cognitive impairment may be related to frontotemporal dementia, Alzheimer's disease and other neurodegenerative disorders in some aspects. An detailed inquiry, a thorough physical check-up and timely clinical examination of electromyogram and discriminating diagnosis are important in diagnosis.