慢性酒精中毒致脑桥中央髓鞘溶解症5例临床分析

Clinical Analysis of 5 Cases of Central Pontine Myelinolysis Due to Chronic Alcoholism

摘要: 目的：分析慢性酒精中毒致脑桥中央髓鞘溶解症(central pontine myelinolysis, CPM)的临床表现，影像特点及治疗预后。方法：对2014-01~2020-06收住广西大化瑶族自治县人民医院住院的CPM患者临床资料进行回顾，结合文献进行分析。结果：5例患者中4例有电解质紊乱，仅1例血电解质正常，4例有电解质紊乱中3例有低钠血症，其中2例有低钠同时并低钾血症、低氯血症，1例有低氯血症。临床主要表现为肢体无力，精神症状，延性麻痹。5例患者均使用类固醇激素治疗，并结合康复治疗，治疗后病情稍好转1例，无明显缓解3例，死亡1例。结论：慢性酒精中毒致脑桥中央髓鞘溶解症患者治疗预后不佳。

Abstract: Objective: To analyze the clinical manifestations, imaging features and prognosis of central pontine myelinolysis (CPM) due to chronic alcoholism. Methods: The clinical data of CPM patients admitted to Dahua Yao Autonomous County People’s Hospital from January 2014 to June 2020 were reviewed and analyzed with the literature. Results: Among the 5 patients, 4 had electrolyte imbalance, of which 3 had hyponatremia, 2 had hypokalemia, hyponatremia and hypochloremia, 1 had hypochloremia. Only 1 patient showed normal serum electrolytes. The main clinical manifestations were limb weakness, mental symptoms, and bulbar paralysis. All 5 patients were treated with steroid therapy combined with rehabilitation therapy. After treatment, 1 patient’s condition improved slightly, 3 patients had no obvious improvement, and 1 patient died. Conclusion: The prognosis of patients with central pontine myelinolysis due to chronic alcoholism is poor.