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目的探讨桥本氏脑病(Hashimoto encephalopathy,HE)的临床特点及诊断。方法回顾性分析2006年1月—2014年1月6例HE患者的临床资料。结果本组男性1例,女性5例,年龄25~66岁,其中2例甲状腺功能亢进,1例甲状腺功能减退,3例甲状腺功能检查结果在正常范围。6例均表现有认知功能损害和意识障碍、精神症状、癫痫发作。6例患者甲状腺过氧化物酶抗体(TPO-Ab)与甲状腺球蛋白抗体(TG-Ab)均升高,CSF蛋白升高2例。脑电图5例异常,均为全脑广泛慢波,头颅磁共振检查3例异常。6例经糖皮质激素治疗后5例均有显著好转,1例患者在诊断明确后激素治疗当天突然死亡。结论 HE多见女性主要表现为不同程度的快速进展性认知功能损害和意识障碍;TPO-Ab、TPO-Ab显著升高。糖皮质激素疗效显著。
Objective To investigate the clinical features and diagnosis of Hashimoto encephalopathy (HE). Methods The clinical data of 6 cases of HE patients from January 2006 to January 2014 were retrospectively analyzed. Results In this group, there were 1 males and 5 females, aged from 25 to 66 years old. Among them, 2 had hyperthyroidism, 1 had hypothyroidism, and 3 had thyroid function test within the normal range. 6 cases showed cognitive impairment and disturbance of consciousness, mental symptoms, seizures. 6 cases of patients with thyroid peroxidase antibody (TPO-Ab) and thyroglobulin antibody (TG-Ab) were elevated, CSF protein increased in 2 cases. 5 cases of EEG abnormalities are extensive slow wave of the whole brain, cranial magnetic resonance imaging abnormalities in 3 cases. Five of the six patients treated with glucocorticoid had a significant improvement, and one patient died suddenly on the day of hormone therapy after diagnosis. CONCLUSIONS: The most common females in HE are mainly those with rapidly progressive cognitive impairment and disturbance of consciousness, and the levels of TPO-Ab and TPO-Ab are significantly increased. Glucocorticoid significant effect.