神经贝赫切特病一例临床分析

摘要

Objective To explore the characteristics of Neuro-Behcet's diease (NBD) and to improve knowledge about the disease. Methods The clinical data of one case with NBD was analyzed retrospectively. The patient had a chief complaint of recurrent oral and genital ulcers for more than 8 years, unclear vision for 2 weeks and aphasia for 3 days. The diagnosis of Behcet's disease (BD) was made. There was some improvement after treatment with frequent relapses. Two weeks ago the patient showed symptoms of unclear vision with a fever( 39℃ ), headache, giddy, delirium and bucking, first misdiagnozed as brain stem lacunar infarction by CT, but later diagnosed as NBD by further related examination and was given intravenous drip of methylprednisolone and oral thalidomide. Results The brain MRI indicated that the focus of infection was obviously reduced when the clinical symptoms improved after treatment. The patient was followed up but was in a stable condition. Conclusion NBD has a higher mortality rate than NB. Early diagnosis and promptly exactitude therapy can obviously increase recovery rates and relieve symptoms, improve life quality and survival rate.%目的 探讨神经贝赫切特病(neuro-Behcet's disease,NBD)的临床特点,以提高对该病的认识.方法 对1例NBD患者的临床资料进行分析.患者因反复口腔及外阴溃疡8年余,视物不清2周,言语不利3 d入院.曾诊断为贝赫切特病(Behcet's disease,BD),给予相应治疗,病情逐渐好转,但反复发作.2周前患者出现视物不清,伴发热、谵语、头痛、头晕,体温最高达39℃,渐出现言语不利,伴轻度呛咳.头颅CT检查可疑脑干腔隙性脑梗死,进一步完善相关检查诊断为NBD.给予甲泼尼龙琥珀酸钠、沙利度胺治疗.结果 患者病情好转,出院.定期来院复诊,复查头颅MRI示病变较前明显缩小,部分病变软化.目前患者病情稳定,仍在随访中.结论 NBD病死率较无神经系统并发症的BD高.早期诊断,及时应用大剂量糖皮质激素,合理使用免疫抑制剂,可缓解病情,提高患者生活质量和生存率.