《桥本脑病》课件.pptVIP

桥本脑病（Hashimoto’s Encephalopathy，HE）;病例-现病史;现病史;查 体;辅助检查（1）;腰 穿;诊断、治疗及预后;桥本脑病8例临床特点;桥本脑病5例临床分析;桥本脑病临床及影像学特点分析;桥本脑病患者的临床特征和预后;桥本脑病（hashimotodisease，HE）;概 述;发病机制;学说（1）;学说（2）;临床表现;临床表现;临床表现;甲状腺功能;实验室检查;实验室检查;实验室检查;;;;;Figure 2. Axial T2-weighted MRI brain scan through the temporal lobes shows bilateral areas of increased signal intensity involving the mesial temporal lobes and hippocampi (arrows). ;HE 病 理;Duffey P. Hashimotos encephalopathy: postmortem findings after fatal status epilepticus. Neurology. 2003 Oct 28;61(8):1124-6. ;The neuropathological features include discrete areas of emyelination (G; areas of pallor on Hematoxylin and Eosin [arrowheads], H; Luxol Fast Blue staining) with relative reservation of axons (I; Bielschowsky staining). The lack of erivascular cuffs is evident in the Hematoxylin and Eosin staining (G).;诊断标准;鉴别诊断;治疗流程;治 疗;治 疗;静脉大剂量激素冲击，通常为泼尼松1—2 mg／kg，随后使用至少lmg／kg维持剂量治疗2—4个月或直至症状缓解，之后再逐渐减少剂量。 然而近来Tokuda等对1例30岁女性HE患者的治疗中发现，大剂量的激素冲击治疗并未改善其临床症状，而口服小剂量激素维持辅以精神心理治疗取得了治愈。;;左旋甲状腺素治疗;血浆置换法、免疫球蛋白;联用其他免疫抑制剂;抗癫痫药物;预 后;展 望;谢　谢 ！