Cao Jie, Su Zhu-Yi, Xu Sha-Bei, Liu Chen-Chen
Eur Neurol. 2018;79(5-6):247-255. doi: 10.1159/000488913. Epub 2018 Apr 26.
The study aimed to analyze the clinical characteristics, laboratory test results, neuroimaging findings, and outcomes in patients diagnosed with subacute combined degeneration (SCD).
A total of 68 patients with SCD who had been appropriately treated for no less than 6 months were included in our study. Histories, results of routine blood tests, biochemical indices, serum vitamin B12 levels, and spinal magnetic resonance imaging (MRI) findings from the patients were studied and analyzed. Clinical signs and symptoms, graded using a functional disability rating scale, were scored at the time of admission and 3 and 6 months after admission.
Limb numbness, limb weakness, and gait disturbances were the most common symptoms in patients with SCD. All patients showed clinical improvement to different degrees at the follow-up visits after vitamin B12 treatment. No differences in rating score were found in patients grouped by sex, hemoglobin level, serum vitamin B12, or MRI manifestations at the time of admission or at the follow-up visits. Younger patients and those with shorter disease courses had better rating scores at the short-term follow-up visits.
Anemia, low levels of serum vitamin B12, and MRI abnormalities in the spinal cord are not expected to be associated with worse clinical manifestations. The age of onset and course of disease are important in evaluating the short-term prognosis of patients with SCD.
本研究旨在分析诊断为亚急性联合变性(SCD)患者的临床特征、实验室检查结果、神经影像学表现及预后。
本研究纳入了68例接受适当治疗不少于6个月的SCD患者。研究并分析了患者的病史、血常规检查结果、生化指标、血清维生素B12水平及脊髓磁共振成像(MRI)表现。采用功能残疾评定量表对临床体征和症状进行分级,在入院时、入院后3个月和6个月进行评分。
肢体麻木、肢体无力和步态障碍是SCD患者最常见的症状。维生素B12治疗后的随访中,所有患者均有不同程度的临床改善。按性别、血红蛋白水平、血清维生素B12或MRI表现分组的患者,在入院时或随访时的评分无差异。年轻患者和病程较短的患者在短期随访中的评分较好。
贫血、血清维生素B12水平低和脊髓MRI异常预计与较差的临床表现无关。发病年龄和病程对评估SCD患者的短期预后很重要。