脊髓亚急性联合变性18例临床分析

目的探讨脊髓亚急性联合变性(SCD)的病因,临床特点的诊断及治疗。方法回顾分析了18例SCD患者的临床特征。结果18例病人平均年龄为57.54±13.48岁。损伤脊髓后索者18例(72%)。血清维生素B12测定检查16例,其中维生素B12降低9例。18例应用维生素B12肌注,2例基本痊愈,13例好转。结论SCD除可累及脊髓后索,侧索中锥体束外,还可累及侧索中脊髓丘脑束。维生素B12缺乏是SCD的主要病因。应用维生素B12是治疗SCD的关键。

To analysis 18 patients of the subacute cobined degeneration of the spinal cord

Objective To study etiological factors, clinical, laboralory features and therapy of patients admitted with subacute combined degeneration （SCD）. Methods Retrospectively analyses eighteen patients with subacte combined degeneration. Results A total of eighteen patients with a mean age of 57.54 ± 13.48 years were studied. All patients damaged dorsal funiculus of spinal cord. Fourteen patients （78%） damaged pyramidal tract of lateral funiculus of spinal cord and five patients （ 28% ） damaged spinothalamic tract of lateral funiculus of spinal cord. Thirteen patients （72%） damaged perpheral nerves. Nine patients of serum vitamin B12 assay in sixteen patients are lower than health adults. After initiation of B12 therapy, all patients showed, of 18 patients included in the analysis, thirteen improved and tow had complete resolution of signs and symptoms. Conclusion SCD can damage not only dorsal funiculus and pyramidal tract of lateral funiculus but also spinothalamic tract of lateral funiculus. Vitamin B12 deficiency is the main cause of SCD. B12 therapy is the key therapy to stop progression and improve SCD.