急性横贯性脊髓炎新诊断标准和分类的临床应用.docVIP

急性横贯性脊髓炎新诊断标准和分类的临床应用 急性横贯性脊髓炎新诊断标准和分类的临床应用 作者：刘占东，王得新，张健，谢琰臣，张春玲，许春玲，薛启蓂 作者单位：100050首都医科大学附属北京友谊医院神经内科 【摘要】 目的 探讨急性横贯性脊髓炎（ATM）新诊断标准和分类的临床应用。 方法 对33例ATM患者的临床资料进行回顾性分析，并与Johes Hopkins 医院神经内科制定的ATM诊断标准和分类方法进行对照。结果 （1）本组患者均为急性起病，其中有6例起病时伴发热，全部病例均出现双下肢瘫痪，病变累及胸髓最多（29例）；（2）与新标准对照，10例符合新标准分型中的伴发感染相关的ATM，7例符合与多发性硬化相关的ATM；1例符合缺血所致的ATM。结论 ATM具有起病快，病因复杂的特点，新标准可能有助于ATM的诊断、疾病分类和发病机制的探讨。 【关键词】 急性横贯性脊髓炎；诊断标准；分类 　　Clinical applications of the novel diagnostic criteria and classification of acute transverse myelitis 　　LIU Zhandong, WANG Dexin, ZHANG Jian, et al. 　　Department of Neurology, Beijing Friendship Hospital Affiliated to Capital University of Medical Science, Beijing 100050，China Abstract：Objective To study clinical applications of the novel diagnostic criteria and classification of acute transverse myelitis (ATM).Methods Retrospective analysis of the clinical data in 33 cases with ATM was carried out according to diagnostic criteria and classification of ATM formulated by Department of Neurology of Johes Hopkins Hospital.Results (1)All of these cases were acute onset and combined fever in 6 patients. All cases manifested bilateral paraparesis or paraplegia. 29 cases were involved in thoracic cord. (2)As compared to the new criteria, 10 cases were ATM accompanied with infection;7 patients were ATM related to multiple sclerosis; 1 patient was ATM caused by ischemic lesions.Conclusions The characteristics of ATM are acute onset and complicated etiology. The novel criteria may be helpful to diagnosis, disease nosology and studies of its pathogenesis. Key words：acute transverse myelitis; diagnostic criteria;classification 　　2002年由Johns Hopkins医院神经内科牵头的急性横贯性脊髓炎（ATM）协作组在总结以往诊断标准的基础上，提出了新的ATM诊断标准和疾病分类方法［1］。本研究依照此标准和疾病分类对我院近年收治的33例ATM患者的临床资料进行对照分析。 1 临床资料 　　1.1 一般资料 系1993～2005年本院临床诊断并入院治疗的ATM患者33例，男14例，女19例；年龄7～67岁，平均（37.9±14）岁，其中30～50岁发病18例（54.5%）；平均病程7.6 d,其中病程1周19例（63.7%）。 　　1.2 临床表现 均为急性起病，