脊髓灰质炎样综合征的临床特征与诊断要点

目的探讨脊髓灰质炎样综合征(PS)的临床特点与诊断要点。方法对15例PS患儿的临床资料包括神经系统表现、实验室及辅助检查、诊断及误诊原因、治疗和转归进行分析。结果15例PS患儿平均起病年龄3.3岁,11例(73%)发病前1~2周或发病时有急性上呼吸道感染或腹泻病史,均表现为肢体急性迟缓性瘫痪,单肢受累者12例(80%)。血清学检查发现柯萨奇病毒IgM阳性4例,EB病毒、单纯疱疹病毒、支原体IgM阳性各1例。患儿肌电图检查均呈神经源性损害肌电图。4例住院期间肌力提高一个等级。结论本征常累及5岁以下儿童,发病前1~2周或发病时多有呼吸道或消化道感染病史,呈急性弛缓性瘫痪,以单肢受累多见,病原多为肠道病毒,肌电图检查有助于明确诊断。

Clinical Characteristics and Diagnosis of Children with Poliomyelitis-Like Syndrome

Objective To investigate the clinical characteristics and diagnostic main points of poliomyelitis-like syndrome(PS).Met-hods The clinical data of 15 children with PS were analyzed retrospectively including nervous system manifestation,results of lab andauxiliary examination,diagnosis and reason of misdiagnosis,treatment and progress.Results PS in all 15 children was characterized by mean age of onset(3.3 years),and forerunner infection(in 11 cases,73%)with acute upper respiratory infection of diarrhea 1-2 weeks pre-onset or during onset.All cases were acute flaccid paralysis,12 cases(80%) of which were only one limb.The positive outcome of serologic examination in PS consisted of 4 cases in coxsackie virus-IgM,1 case in EB virus-IgM,1 case in herpes simplex virus-IgM and 1 case in mycoplasma-IgM.All children showed the electromyologram changes in nerve damage.The muscle force of 4 cases increased one grade.Conclusions Children with PS are characterized by the age of onset under 5 years old,acute flaccid paralysis(mostly affected one limb),and the most pathogen being enterovirus.The electromyologram examination can help establish a definite diagnosis in PS.