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中国3例散发性克雅氏病病例及其临床分析。

Three sporadic cases of Creutzfeldt-Jakob disease in China and their clinical analysis.

作者信息

Wang Xingbang, Li Na, Liu Aifen, Ma Lin, Shan Peiyan, Jiang Wenjing, Zhang Qun

机构信息

Department of Neurology, Cadre Clinic, Qilu Hospital of Shandong University, Jinan, Shandong 250012, P.R. China.

Department of Dermatology, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250011, P.R. China.

出版信息

Exp Ther Med. 2017 Sep;14(3):2664-2670. doi: 10.3892/etm.2017.4832. Epub 2017 Jul 25.

Abstract

The present study described the characteristics of three cases of Creutzfeldt-Jakob disease (CJD) in China and analyzed their clinical presentations. The clinical information of the three cases was collected and analyzed. Blood and cerebrospinal fluid (CSF) specimens of the patients were collected for detection of the prion protein (PRNP) gene and 14-3-3 protein levels. Dynamic changes of electroencephalograms (EEGs) and brain magnetic resonance images (MRIs) were also observed. All the three cases were sporadic CJD cases. They presented with symptoms including hyposthenia, progressive memory loss, truncal and limb ataxia, dysarthria, lowered vision acuity, bucking, language disorders, myoclonia and akinetic mutism state. One of the three cases was associated with a prolonged duration of >6 years. The EEG of two cases showed slow biphasic waves. The diffusion-weighted MRI sequence revealed abnormal hyperintensity and bilateral ribboning in the cortex. Two patients tested positive for the 14-3-3 protein in the CSF. All patients were of methionine homozygosity at codon 129 in the gene encoding PRNP protein and one patient had a mutation. The CJD cases showed differences in terms of symptoms and disease duration. Subacute onset was common and with attentive nursing and supportive treatments, one of the patients had a prolonged survival time of >6 years.

摘要

本研究描述了中国3例克雅氏病(CJD)的特征并分析了其临床表现。收集并分析了这3例患者的临床信息。采集患者的血液和脑脊液(CSF)标本以检测朊蛋白(PRNP)基因和14-3-3蛋白水平。还观察了脑电图(EEG)和脑磁共振成像(MRI)的动态变化。所有3例均为散发性CJD病例。他们表现出包括肌无力、进行性记忆丧失、躯干和肢体共济失调、构音障碍、视力下降、肌阵挛、语言障碍、肌阵挛和无动性缄默状态等症状。3例中有1例病程超过6年。2例患者的脑电图显示慢双相波。弥散加权MRI序列显示皮质异常高信号和双侧带状影。2例患者脑脊液中14-3-3蛋白检测呈阳性。所有患者在编码PRNP蛋白的基因第129密码子处均为甲硫氨酸纯合子,1例患者有突变。CJD病例在症状和病程方面存在差异。亚急性起病较为常见,经过精心护理和支持治疗,其中1例患者存活时间延长超过6年。

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