Kay A C, Solberg L A, Nichols D A, Petitt R M
Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905.
Mayo Clin Proc. 1991 Jun;66(6):602-7. doi: 10.1016/s0025-6196(12)60519-9.
We studied the prognostic value of computed tomography (CT) of the brain for neurologic morbidity in patients with thrombotic thrombocytopenic purpura. On review of Mayo Clinic records for 1975 through 1985, we found 32 patients with thrombotic thrombocytopenic purpura, 20 of whom had undergone CT of the brain during their hospitalization. Despite major neurologic symptoms and signs, normal CT findings were associated with complete neurologic recovery. Seventy percent of patients with normal results of CT of the brain recovered and had no neurologic deficits, whereas 80% of patients with CT abnormalities died or had permanent neurologic sequelae. A review of the literature supports these conclusions. Thus, we suggest that CT of the brain be done in any patient with thrombotic thrombocytopenic purpura and neurologic deficits. Regardless of the severity of neurologic involvement, normal CT findings should encourage continued vigorous treatment of the patient because a normal scan supports the possibility of full clinical recovery.
我们研究了脑部计算机断层扫描（CT）对血栓性血小板减少性紫癜患者神经功能病变的预后价值。回顾梅奥诊所1975年至1985年的记录，我们发现32例血栓性血小板减少性紫癜患者，其中20例在住院期间接受了脑部CT检查。尽管有严重的神经症状和体征，但CT结果正常与神经功能完全恢复相关。脑部CT结果正常的患者中有70%康复且无神经功能缺损，而CT异常的患者中有80%死亡或有永久性神经后遗症。文献综述支持这些结论。因此，我们建议对任何有血栓性血小板减少性紫癜和神经功能缺损的患者进行脑部CT检查。无论神经受累的严重程度如何，CT结果正常都应鼓励对患者继续进行积极治疗，因为扫描结果正常支持临床完全康复的可能性。
