{"id":39807,"date":"2018-08-29T01:00:00","date_gmt":"2018-09-17T06:35:32","guid":{"rendered":"http:\/\/www.05921.net\/index.php\/2018\/09\/17\/%e5%bc%82%e7%97%85%e5%90%8c%e8%b1%a1%ef%bc%9a%e9%9a%be%e4%bb%a5%e9%89%b4%e5%88%ab%e7%9a%84%e8%87%aa%e8%ba%ab%e5%85%8d%e7%96%ab%e6%80%a7%e8%84%91%e7%82%8e%e5%92%8c%e5%85%8b%e9%9b%85%e7%97%85\/"},"modified":"2018-09-17T14:35:35","modified_gmt":"2018-09-17T06:35:35","slug":"%e5%bc%82%e7%97%85%e5%90%8c%e8%b1%a1%ef%bc%9a%e9%9a%be%e4%bb%a5%e9%89%b4%e5%88%ab%e7%9a%84%e8%87%aa%e8%ba%ab%e5%85%8d%e7%96%ab%e6%80%a7%e8%84%91%e7%82%8e%e5%92%8c%e5%85%8b%e9%9b%85%e7%97%85","status":"publish","type":"post","link":"https:\/\/www.05921.net\/index.php\/39807\/","title":{"rendered":"\u5f02\u75c5\u540c\u8c61\uff1a\u96be\u4ee5\u9274\u522b\u7684\u81ea\u8eab\u514d\u75ab\u6027\u8111\u708e\u548c\u514b\u96c5\u75c5"},"content":{"rendered":"
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\u795e\u7ecf\u65f6\u95f4\u5bfc\u8bfb<\/strong><\/p>\n<\/section>\n<\/section>\n

\n


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\u75c5\u4f8b 1<\/span><\/strong><\/span><\/p>\n

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69 \u5c81\u7537\u6027\uff0c\u65e2\u5f80\u6709\u62bd\u70df\u53f2\u548c\u9707\u98a4\uff0c\u672c\u6b21\u56e0\u5feb\u901f\u8fdb\u5c55\u6027\u75f4\u5446\u5c31\u8bca\u30023 \u5468\u524d\uff0c\u60a3\u8005\u51fa\u73b0\u610f\u8bc6\u6a21\u7cca\uff0c\u9010\u6e10\u52a0\u91cd\uff0c\u9707\u98a4\u4e5f\u66f4\u52a0\u660e\u663e\uff0c\u8bb0\u5fc6\u529b\u4e0b\u964d\uff0c\u8a00\u8bed\u9519\u4e71\uff0c\u5e76\u6709\u884c\u8d70\u56f0\u96be\u3002\u75c5\u7a0b\u4e2d\u8fd8\u5b58\u5728\u9762\u808c\u9635\u631b\uff0c\u53f3\u4fa7\u5ffd\u89c6\u548c\u4e25\u91cd\u7684\u5171\u6d4e\u5931\u8c03\u3002\u60a3\u8005\u8840\u94a0\u7a0d\u504f\u4f4e\uff08133 mmol\/L\uff09\uff0c\u8111\u810a\u6db2 14-3-3 \u86cb\u767d\u9633\u6027\uff0ctau \u86cb\u767d\u8f7b\u5ea6\u5347\u9ad8\u3002\u8111\u7535\u56fe\u63d0\u793a\u4f4e\u7535\u538b\uff0c\u5de6\u4fa7\u534a\u7403\u5448\u8f7b\u5ea6\u6162\u6ce2\u5316\u6539\u53d8\uff0c\u672a\u89c1\u5468\u671f\u6027\u5c16\u6162\u590d\u5408\u6ce2\u3002<\/p>\n


<\/p>\n

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<\/p>\n

\u6700\u7ec8\u8bca\u65ad\uff1aVGKC \u6297\u4f53\u8111\u708e\u3002<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

\n
<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n


\"\u5f02\u75c5\u540c\u8c61\uff1a\u96be\u4ee5\u9274\u522b\u7684\u81ea\u8eab\u514d\u75ab\u6027\u8111\u708e\u548c\u514b\u96c5\u75c5\"
\u56fe 1 A~<\/span>B\uff1aDWI \u53ef\u89c1\u5de6\u4fa7\u5927\u8111\u534a\u7403\u76ae\u5c42\u98d8\u5e26\u6837\u9ad8\u4fe1\u53f7\uff0c\u76f8\u5e94\u90e8\u4f4d ADC \u4e3a\u4f4e\u4fe1\u53f7\uff0c\u63d0\u793a\u5f25\u6563\u53d7\u9650\uff1b\u4ee5\u5de6\u4fa7\u6954\u524d\u53f6 [\u7c97\u7bad] \u548c\u76ae\u5c42\u7070\u8d28 [\u7ec6\u7bad] \u6700\u4e3a\u660e\u663e\uff0c\u53cc\u4fa7\u5c3e\u72b6\u6838\u548c\u58f3\u6838\u672a\u89c1\u660e\u663e\u5f02\u5e38\uff1bC\uff1aFLAIR \u4e0a\u5de6\u4fa7\u76ae\u5c42\u672a\u89c1\u660e\u663e\u9ad8\u4fe1\u53f7 1<\/sup><\/span><\/p>\n

\"\u5f02\u75c5\u540c\u8c61\uff1a\u96be\u4ee5\u9274\u522b\u7684\u81ea\u8eab\u514d\u75ab\u6027\u8111\u708e\u548c\u514b\u96c5\u75c5\"
\u56fe 2 D<\/span>~F<\/span>\uff1a\u5de6\u4fa7\u540e\u90e8\u6263\u5e26\u56de\uff0c\u540e\u90e8\u989d\u53f6\u76ae\u5c42\uff0c\u6795\u53f6\uff0c\u4e18\u8111\u548c\u6954\u524d\u53f6\u9ad8\u4ee3\u8c22 1<\/sup><\/span><\/p>\n

\u75c5\u4f8b 2<\/strong><\/span><\/p>\n

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58 \u5c81\u7537\u6027\uff0c\u56e0\u95f4\u65ad\u6027\u610f\u8bc6\u969c\u788d\uff0c\u8bb0\u5fc6\u529b\u4e0b\u964d\u548c\u9762\u3001\u624b\u62bd\u52a8 2~3 \u6708\u5c31\u8bca\u4e8e\u5916\u9662\uff0c\u5934\u9885 MRI \u63d0\u793a\u53f3\u4fa7\u5c3e\u72b6\u6838\uff0c\u58f3\u6838\uff0c\u53cc\u4fa7\u989e\u53f6\u5185\u4fa7\u9762\uff08\u5de6\u4fa7\u660e\u663e\uff09T2WI\/FLAIR \u9ad8\u4fe1\u53f7\uff0cDWI \u4e0a\u53f3\u4fa7\u5c3e\u72b6\u6838\u548c\u58f3\u6838\u4e5f\u4e3a\u9ad8\u4fe1\u53f7\uff0c\u800c ADC \u6b63\u5e38\uff08\u5982\u56fe 3\uff09\u3002\u60a3\u8005\u8840\u94a0\u7a0d\u504f\u4f4e\uff08131 mmol\/L\uff09\uff0c\u8111\u810a\u6db2\u5e38\u89c4\u548c\u751f\u5316\u65e0\u6b8a\uff0c\u4f46 14-3-3 \u86cb\u767d\u9633\u6027\u3002<\/p>\n


<\/p>\n

\u5916\u9662\u8bca\u65ad\u4e3a CJD\u30022 \u6708\u540e\uff0c\u60a3\u8005\u51fa\u73b0\u5168\u9762\u6027\u53d1\u4f5c\uff0c\u5148\u524d\u75c7\u72b6\u8fdb\u4e00\u6b65\u52a0\u91cd\uff0c\u5165\u9662\u540e\u89c2\u5bdf\u5230\u9891\u7e41\u7684\u9762\u3001\u624b\u62bd\u52a8\uff08\u8d77\u521d\u8ba4\u4e3a\u662f\u808c\u9635\u631b\uff09\uff0c\u6bcf\u6b21\u6301\u7eed 0.5~2 \u79d2\uff0c\u65e0\u76f8\u5e94\u7684\u8111\u7535\u56fe\u6539\u53d8\uff0c\u8003\u8651\u4e3a\u9762-\u81c2\u808c\u5f20\u529b\u969c\u788d\u6837\u53d1\u4f5c\uff0c\u4f46\u89c6\u9891\u8111\u7535\u56fe\u786e\u5b9e\u4e5f\u6355\u6349\u5230\u6570\u6b21\u989e\u53f6\u766b\u75eb\u53d1\u4f5c\u3002PET \u68c0\u67e5\u63d0\u793a\u5de6\u4fa7\u5c3e\u72b6\u6838\u548c\u53cc\u4fa7\u58f3\u6838\uff08\u5de6\u4fa7\u660e\u663e\uff09\u9ad8\u4ee3\u8c22\uff08\u5982\u56fe 4\uff09\u3002<\/p>\n


<\/p>\n

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<\/p>\n


<\/p>\n

\u6700\u7ec8\u8bca\u65ad\uff1aVGKC \u6297\u4f53\u8111\u708e\u3002<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

\n
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\"\u5f02\u75c5\u540c\u8c61\uff1a\u96be\u4ee5\u9274\u522b\u7684\u81ea\u8eab\u514d\u75ab\u6027\u8111\u708e\u548c\u514b\u96c5\u75c5\"
\u56fe 3 FLAIR \u4e0a\u53ef\u89c1\u53f3\u4fa7\u5c3e\u72b6\u6838\u548c\u58f3\u6838\uff08A\uff0c\u7bad\u5934\uff09\u9ad8\u4fe1\u53f7\u4ee5\u53ca\u53cc\u4fa7\u989e\u53f6\u5185\u4fa7\u9762\u9ad8\u4fe1\u53f7\uff0c\u5de6\u4fa7\u66f4\u660e\u663e\uff08B\uff0c\u7bad\u5934\uff09\uff1bDWI \u63d0\u793a\u53f3\u4fa7\u5c3e\u72b6\u6838\u548c\u58f3\u6838\u9ad8\u4fe1\u53f7\uff08C\uff09\uff0c\u5bf9\u5e94\u90e8\u4f4d ADC \u4e0a\u672a\u89c1\u4f4e\u4fe1\u53f7\uff08D\uff092<\/sup><\/span><\/p>\n

\"\u5f02\u75c5\u540c\u8c61\uff1a\u96be\u4ee5\u9274\u522b\u7684\u81ea\u8eab\u514d\u75ab\u6027\u8111\u708e\u548c\u514b\u96c5\u75c5\"
\u56fe 4 PET \u63d0\u793a\u5de6\u4fa7\u5c3e\u72b6\u6838\u548c\u58f3\u6838\u9ad8\u4ee3\u8c22\uff0c\u53f3\u4fa7\u58f3\u6838\u9ad8\u4ee3\u8c22\u4e0d\u5982\u5de6\u4fa7\u660e\u663e 2<\/sup><\/span><\/p>\n

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\u8bc4\u8bba 1<\/strong><\/span><\/p>\n<\/section>\n

<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n


\u5f71\u50cf\u5b66\u4e0a DWI \u5bf9\u4e8e CJD \u7684\u8bca\u65ad\u6709\u5f88\u9ad8\u7684\u654f\u611f\u6027\u548c\u7279\u5f02\u6027\uff0c\u5e38\u8868\u73b0\u4e3a\u76ae\u5c42\u98d8\u5e26\u5f81\u4ee5\u53ca\u57fa\u5e95\u8282\u533a\uff08\u7279\u522b\u662f\u5c3e\u72b6\u6838\u548c\u58f3\u6838\uff09\u9ad8\u4fe1\u53f7\u3002CJD \u76f8\u5bf9\u7279\u5f81\u6027\u7684\u8111\u7535\u56fe\u6539\u53d8\uff0c\u5373\u5468\u671f\u6027\u5c16\u6162\u590d\u5408\u6ce2\u4ec5\u89c1\u4e8e 50~70% \u7684\u60a3\u8005\uff0c\u4e14\u591a\u5728\u53d1\u75c5 3 \u4e2a\u6708\u6216\u4ee5\u540e\u624d\u51fa\u73b0\u3002\u8111\u810a\u6db2\u4e2d\u4ee5 tau \u4e0e 14-3-3 \u86cb\u767d\u8f83\u4e3a\u654f\u611f\u3002\u672c\u75c5\u6700\u7ec8\u660e\u786e\u4ecd\u9700\u75c5\u7406\u3002
<\/p>\n

VGKC \u6297\u4f53\u4e3b\u8981\u89c1\u4e8e\u795e\u7ecf\u6027\u808c\u5f3a\u76f4\u3001\u81ea\u8eab\u514d\u75ab\u6027\u8111\u708e\u3001Morvan \u7efc\u5408\u5f81\u7b49\u75be\u75c5\u3002\u8fd1\u6765\u7814\u7a76\u663e\u793a\u9488\u5bf9 VGKCs \u4e9a\u578b Kv1.1 \u548c Kv1.2 \u7684\u6297\u4f53\u5b9e\u9645\u4e0a\u5f88\u5c11\uff0c\u800c\u53c2\u4e0e\u6784\u6210 VGKC \u7684 LGI1 \u548c Caspr2 \u662f\u4e3b\u8981\u7684\u81ea\u8eab\u6297\u539f\u3002<\/p>\n

VGKC \u6297\u4f53\u8111\u708e\u7d2f\u53ca\u8fb9\u7f18\u53f6\u8f83\u5e38\u89c1\uff0c\u4e34\u5e8a\u4e0a\u4e3b\u8981\u8868\u73b0\u4e3a\u8ba4\u77e5\u529f\u80fd\u4e0b\u964d\uff0c\u7cbe\u795e\u75c7\u72b6\uff0c\u766b\u75eb\u53d1\u4f5c\u548c\u7761\u7720\u969c\u788d\u7b49\u3002\u5f71\u50cf\u5b66\u4e0a\u591a\u53ef\u89c1 T2WI\/FLAIR \u9ad8\u4fe1\u53f7\u3002\u8840\u6e05\u6216\u8111\u810a\u6db2\u4e2d VGKC \u6297\u4f53\u9633\u6027\u6709\u52a9\u4e8e\u8bca\u65ad\u3002
<\/p>\n

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<\/p>\n

\"\u5f02\u75c5\u540c\u8c61\uff1a\u96be\u4ee5\u9274\u522b\u7684\u81ea\u8eab\u514d\u75ab\u6027\u8111\u708e\u548c\u514b\u96c5\u75c5\"
\u56fe 5 \u4e00\u4f8b VGKC \u6297\u4f53\u8111\u708e\u60a3\u8005\uff0cDWI \u4e0a\u53ef\u89c1\u76ae\u5c42\u9ad8\u4fe1\u53f7 5<\/sup><\/span><\/p>\n

\u8fd9\u4e48\u795e\u4f3c\u7684\u4e24\u79cd\u75c5\uff0c\u5e94\u8be5\u5982\u4f55\u533a\u5206\u5462\uff1f<\/strong><\/p>\n

\u9996\u5148\uff0c\u4ece\u4e34\u5e8a\u89d2\u5ea6\u770b\uff0cVGKC \u6297\u4f53\uff08\u4e3b\u8981\u4e3a LGI-1 \u6297\u4f53\uff09\u8111\u708e\u7684\u5178\u578b\u7279\u5f81\u4e4b\u4e00\u4e3a\u9762-\u81c2\u808c\u5f20\u529b\u969c\u788d\u6837\u53d1\u4f5c\uff08\u5982\u75c5\u4f8b 2\uff09\uff0c\u9700\u6ce8\u610f\u4e0e\u808c\u9635\u631b\u9274\u522b\uff0c\u907f\u514d\u8bef\u8bca\u3002\u524d\u8005\u9ad8\u5ea6\u523b\u677f\uff0c\u53d1\u4f5c\u76f8\u5f53\u9891\u7e41\uff08\u53ef\u9ad8\u8fbe 50 \u6b21\/\u5929\uff09\uff0c\u591a\u4e3a\u5355\u4fa7\uff0c\u4e0a\u81c2\u5e38\u548c\u9762\u90e8\u8fd0\u52a8\u540c\u6b65\uff0c\u6709\u65f6\u8fd8\u53ef\u7d2f\u53ca\u4e0b\u80a2\uff0c\u53d1\u4f5c\u65f6\u95f4\u901a\u5e38\u6bd4\u8f83\u77ed\u6682\uff0c\u4e00\u822c\uff1c3 \u79d2\uff0c\u4f46\u76f8\u6bd4\u808c\u9635\u631b\u52a8\u4f5c\u8981\u6162\u3002\u503c\u5f97\u4e00\u63d0\u7684\u662f\uff0cVGKC \u6297\u4f53\u8111\u708e\u8fd8\u53ef\u5408\u5e76\u80bf\u7624\uff0c\u5fc5\u8981\u65f6\u9700\u8fdb\u884c\u5168\u8eab\u7b5b\u67e5\u3002<\/p>\n

\u5176\u6b21\uff0c\u4f4e\u94a0\u8840\u75c7\u662f VGKC \u6297\u4f53\u8111\u708e\u7684\u53e6\u4e00\u7279\u5f81\uff0c\u5bf9\u8bca\u65ad\u6709\u63d0\u793a\u610f\u4e49\u3002\u518d\u8005\uff0c\u4ece\u5f71\u50cf\u5b66\u89d2\u5ea6\uff0cPET \u53ef\u80fd\u6709\u52a9\u4e8e\u9274\u522b CJD \u548c VGKC \u6297\u4f53\u8111\u708e\uff0c\u6392\u9664\u611f\u67d3\u6216\u80bf\u7624\u540e\uff0c\u9ad8\u4ee3\u8c22\u75c5\u7076\u591a\u63d0\u793a\u81ea\u8eab\u514d\u75ab\u8fc7\u7a0b\u3002\u6700\u540e\uff0c\u4e5f\u53ef\u80fd\u6700\u5173\u952e\u7684\uff0c\u5f53\u7136\u662f\u8981\u67e5\u8840\u6e05\u548c\uff08\u6216\uff09\u8111\u810a\u6db2\u4e2d\u7684 VGKC \u6297\u4f53\u6c34\u5e73\u4e86\u3002
<\/p>\n

\u8377\u5170\u7684\u4e00\u9879\u5bf9 14 \u5e74\u65f6\u95f4\uff081998~<\/span>2011\uff09\u5171 384 \u4f8b\u6000\u7591 CJD \u7684\u60a3\u8005\u5c38\u68c0\u7814\u7a76\u53d1\u73b0\uff0c203 \u4f8b\u786e\u8bca\u4e3a CJD\uff0c\u800c\u4f59\u4e0b\u7684 181 \u4f8b\u4e2d\uff0c\u6709 22 \u4f8b\u4e3a\u81ea\u8eab\u514d\u75ab\u6027\u8111\u708e\u3002\u53ef\u89c1\uff0cCJD \u8bca\u65ad\u65f6\u9274\u522b\u81ea\u8eab\u514d\u75ab\u6027\u8111\u708e\u76f8\u5f53\u91cd\u8981\u3002
<\/p>\n

\u770b\u5230\u8fd9\u91cc\uff0c\u5927\u5bb6\u53ef\u80fd\u89c9\u5f97\u95ee\u9898\u5df2\u7ecf\u89e3\u51b3\u4e86\uff0c\u8bf4\u6765\u8bf4\u53bb\uff0c\u4e0d\u5c31\u662f\u67e5\u4e2a\u6297\u4f53\u5417\uff1f\u53ea\u8981\u6709\u6297\u4f53\u5347\u9ad8\uff0c\u5c31\u53ef\u4ee5\u6392\u9664 CJD\uff0c\u591a\u8f7b\u677e\u554a\u3002\u7136\u800c\u8fd9\u53ea\u662f\u6211\u4eec\u7684\u7f8e\u597d\u613f\u671b\u800c\u5df2\uff0c\u4e8b\u5b9e\u8fdc\u6ca1\u6709\u90a3\u4e48\u7b80\u5355\u3002\u6211\u4eec\u518d\u6765\u770b 2 \u4e2a\u75c5\u4f8b\u3002<\/p>\n

\u75c5\u4f8b 3<\/strong><\/span><\/p>\n

\n
\n
\n
\n
\n
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\n

75 \u5c81\u5973\u6027\uff0c\u56e0\u5feb\u901f\u8fdb\u5c55\u6027\u8ba4\u77e5\u529f\u80fd\u7f3a\u635f\u5165\u9662\u300210 \u5929\u524d\uff0c\u60a3\u8005\u4e08\u592b\u6ce8\u610f\u5230\u5176\u77ed\u6682\u7684\u5b9a\u5411\u529b\u969c\u788d\u548c\u610f\u8bc6\u6a21\u7cca\u3002\u5165\u9662\u67e5\u4f53\u53d1\u73b0\u60a3\u8005\u8ba4\u77e5\u9886\u57df\u7684\u6240\u6709\u529f\u80fd\u5747\u6709\u4e0b\u964d\uff0c\u8fd0\u52a8\u3001\u611f\u89c9\u548c\u5171\u6d4e\u6b63\u5e38\u3002\u8111\u7535\u56fe\uff0c\u78c1\u5171\u632f\u53ca\u8170\u7a7f\u5747\u4e3a\u975e\u7279\u5f02\u6027\u7ed3\u679c\u3002\u81ea\u8eab\u514d\u75ab\u6027\u8111\u708e\u6297\u4f53\u7b5b\u67e5\u8840\u4e2d Caspr2\uff08VGKC \u590d\u5408\u4f53\u7ec4\u6210\u90e8\u5206\u4e4b\u4e00\uff09\u6297\u4f53\u9633\u6027\u3002<\/p>\n


<\/p>\n

\u60a3\u8005\u63a5\u53d7\u514d\u75ab\u6cbb\u7597\u540e Caspr2 \u6297\u4f53\u6ef4\u5ea6\u4e0b\u964d\uff0c\u4f46\u75c7\u72b6\u8fdb\u4e00\u6b65\u6076\u5316\uff0c\u590d\u67e5 MRI \u53ef\u89c1 T2WI\/FLAIR \u57fa\u5e95\u8282\u533a\u5bf9\u79f0\u9ad8\u4fe1\u53f7\uff0c\u590d\u67e5\u8111\u810a\u6db2\u4e2d 14-3-3 \u86cb\u767d\u9633\u6027\uff0ctau \u86cb\u767d\u5347\u9ad8\u3002\u60a3\u8005\u8d77\u75c5 1 \u5e74\u5de6\u53f3\u6b7b\u4ea1\u3002\u5c38\u68c0\u8bc1\u5b9e\u6d77\u7ef5\u72b6\u8111\u75c5\u3002<\/p>\n


<\/p>\n

\u6700\u7ec8\u8bca\u65ad\uff1aCJD\u3002<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

\n
<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n


\"\u5f02\u75c5\u540c\u8c61\uff1a\u96be\u4ee5\u9274\u522b\u7684\u81ea\u8eab\u514d\u75ab\u6027\u8111\u708e\u548c\u514b\u96c5\u75c5\"
\u56fe 6 2 \u6708\u540e\u7684 MRI \u4e0a\u53ef\u89c1\u57fa\u5e95\u8282\u533a\u5bf9\u79f0 T2WI\/FLAIR \u9ad8\u4fe1\u53f7\uff0c\u4ee5\u58f3\u6838\u548c\u5c3e\u72b6\u6838\u5934\u6700\u4e3a\u660e\u663e 3<\/sup><\/span><\/p>\n

\u75c5\u4f8b 4<\/strong><\/span><\/p>\n

\n
\n
\n
\n
\n
\n
\n

64 \u5c81\u5973\u6027\uff0c\u8fdb\u884c\u6027\u6b65\u6001\u4e0d\u7a33\u4f34\u610f\u8bc6\u6a21\u7cca 17 \u6708\u3002\u5934\u9885 MRI \u63d0\u793a\u57fa\u5e95\u8282\u533a\/\u4e18\u8111\u548c\u5927\u8111\u76ae\u5c42\uff0c\u5305\u62ec\u9876\u53f6\uff0c\u6795\u53f6\u548c\u989d\u53f6\u533a\u57df\u5f25\u6563\u53d7\u9650\u3002\u8170\u7a7f\u63d0\u793a 14-3-3 \u86cb\u767d\u9633\u6027\uff0ctau \u86cb\u767d\u5347\u9ad8\u3002\u8840\u6e05 VGKC \u6297\u4f53\u9633\u6027\u3002\u5f53\u65f6\u8003\u8651\u81ea\u8eab\u514d\u75ab\u6027\u8111\u708e\uff0c\u51c6\u5907\u7ed9\u4e88\u514d\u75ab\u6cbb\u7597\uff0c\u4f46\u5c1a\u672a\u5f00\u59cb\u60a3\u8005\u5c31\u5df2\u6b7b\u4ea1\uff0c\u5c38\u68c0\u75c5\u7406\u5b66\u63d0\u793a\u6d77\u7ef5\u72b6\u8111\u75c5\u3002<\/p>\n


<\/p>\n

\u6700\u7ec8\u8bca\u65ad\uff1aCJD\u3002<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

\n

<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n


\"\u5f02\u75c5\u540c\u8c61\uff1a\u96be\u4ee5\u9274\u522b\u7684\u81ea\u8eab\u514d\u75ab\u6027\u8111\u708e\u548c\u514b\u96c5\u75c5\"
\u56fe 7 A~<\/span>B\uff1aDWI \u548c ADC \u53ef\u89c1\u76ae\u5c42\u548c\u57fa\u5e95\u8282\u533a\u5f25\u6563\u53d7\u9650\uff1bC\uff1aFLAIR \u4e0a\u4ea6\u53ef\u89c1\u90e8\u5206\u9ad8\u4fe1\u53f7\u75c5\u7076\uff1bD\uff1a\u589e\u5f3a\u540e\u75c5\u7076\u65e0\u660e\u663e\u5f3a\u5316 4<\/sup><\/span><\/p>\n

\n
\n
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\u8bc4\u8bba 2<\/strong><\/span><\/p>\n<\/section>\n

<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n


\u5728\u75c5\u4f8b 3 \u548c 4 \u4e2d\uff0c\u5747\u5b58\u5728 VGKC \u6297\u4f53\u5347\u9ad8\uff0c\u4f46\u6700\u7ec8\u75c5\u7406\u786e\u8bca\u4e3a CJD\u3002\u53ef\u89c1\u4e24\u8005\u7684\u9274\u522b\u8fd8\u9700\u8865\u5145\u4ee5\u4e0b\u51e0\u70b9\uff1a\u9996\u5148\u662f\u75c5\u7a0b\uff0c\u6bd4\u8f83\u53ef\u9760\uff0c\u6000\u7591 CJD \u7684\u60a3\u8005\u5982\u5b58\u6d3b 1 \u5e74\u4ee5\u4e0a\u7279\u522b\u662f\u8d85\u8fc7 2 \u5e74\u65f6\u9700\u91cd\u65b0\u8003\u8651\u5176\u4ed6\u8bca\u65ad\uff1b\u5176\u6b21\u662f\u6cbb\u7597\u6548\u679c\uff0cCJD \u76ee\u524d\u5c1a\u4e0d\u53ef\u6cbb\uff0c\u800c VGKC \u6297\u4f53\u8111\u708e\u591a\u5bf9\u514d\u75ab\u6291\u5236\u6cbb\u7597\u53cd\u5e94\u8f83\u597d\u3002\u6700\u540e\uff0c\u75c5\u7406\u4f9d\u7136\u662f\u7ec8\u6781\u738b\u724c\u6b66\u5668\uff0c\u4e5f\u662f\u8bca\u65ad\u7684\u91d1\u6807\u51c6\u3002<\/p>\n

\u82f1\u56fd\u7684\u4e00\u9879\u7814\u7a76\u663e\u793a\uff0c\u4ec5\u6709\u4e0d\u5230 5% \u7684 CJD \u60a3\u8005\u4e2d\u68c0\u6d4b\u5230\u795e\u7ecf\u5143\u6297\u4f53\uff0c\u5373\u4fbf\u9633\u6027\uff0c\u6ef4\u5ea6\u4e5f\u5f88\u4f4e\u3002\u6709 3 \u4f8b\u8003\u8651\u53ef\u80fd\u7684 CJD \u60a3\u8005\u4e2d VGKC \u6297\u4f53\u6ef4\u5ea6\u5f88\u9ad8\uff0c\u5c3d\u7ba1 2 \u4f8b\u672a\u6765\u5f97\u53ca\u6cbb\u7597\u4fbf\u6b7b\u4ea1\uff0c\u4f46\u4f59\u4e0b 1 \u4f8b\u514d\u75ab\u6cbb\u7597\u540e\u597d\u8f6c\u3002<\/p>\n

\u56e0\u6b64\uff0c\u5b66\u8005\u4eec\u8ba4\u4e3a\uff0cCJD \u60a3\u8005\u4e2d\u5408\u5e76\u795e\u7ecf\u5143\u6297\u4f53\u9633\u6027\u975e\u5e38\u7f55\u89c1\uff0c\u82e5\u6297\u4f53\u6ef4\u5ea6\u5f88\u9ad8\uff0c\u66f4\u503e\u5411\u4e8e\u81ea\u8eab\u514d\u75ab\u6027\u8111\u708e\u7684\u8bca\u65ad\u3002\u786e\u8bca CJD \u60a3\u8005\u4e2d\u5408\u5e76 VGKC \u6297\u4f53\u9633\u6027\u7684\u539f\u56e0\u5c1a\u4e0d\u6e05\u695a\uff0c\u6709\u5b66\u8005\u63a8\u6d4b\u670a\u86cb\u767d\u4ecb\u5bfc\u7684\u795e\u7ecf\u9000\u884c\u6027\u53d8\u53ef\u80fd\u89e6\u53d1\u4e86\u5468\u56f4\u6dcb\u5df4\u7ed3\u7684\u514d\u75ab\u53cd\u5e94\uff0c\u5bfc\u81f4\u4ea7\u751f\u9488\u5bf9\u795e\u7ecf\u5143\u7ed3\u6784\uff08\u5982 VGKC\uff09\u7684\u6297\u4f53\u3002\u4f46\u8fd8\u9700\u8981\u8fdb\u4e00\u6b65\u7814\u7a76\u9610\u660e\u3002<\/p>\n

\n
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\n
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\n
\n

\u603b \u7ed3<\/strong><\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
<\/section>\n
<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n


VGKC \u6297\u4f53\u8111\u708e\uff08\u6216\u5176\u4ed6\u81ea\u8eab\u514d\u75ab\u6027\u8111\u708e\uff09\u548c CJD \u53ef\u4ee5\u6709\u76f8\u4f3c\u7684\u4e34\u5e8a\uff0c\u5f71\u50cf\u5b66\uff0c\u7535\u751f\u7406\u4ee5\u53ca\u5b9e\u9a8c\u5ba4\u68c0\u67e5\u7279\u70b9\u3002\u4f46\u4e00\u822c\u6765\u8bf4\u5feb\u901f\u8fdb\u884c\u6027\u75f4\u5446\u4f34\u5c40\u7076\u6027\u795e\u7ecf\u529f\u80fd\u7f3a\u635f\uff0c\u5982\u5931\u8bed\uff0c\u6b65\u6001\u5f02\u5e38\u548c\u89c6\u89c9\u969c\u788d\u7b49\u63d0\u793a CJD \u7684\u53ef\u80fd\u6027\u5927\uff0c\u800c\u766b\u75eb\u53d1\u4f5c\uff0c\u4f4e\u94a0\u8840\u75c7\u548c\u81ea\u4e3b\u795e\u7ecf\u75c7\u72b6\u7684\u51fa\u73b0\u5219\u662f\u81ea\u8eab\u514d\u75ab\u6027\u8111\u708e\u7684\u8bca\u65ad\u7ebf\u7d22\u3002<\/p>\n

CJD \u662f\u4e00\u79cd\u81f4\u6b7b\u6027\u75be\u75c5\uff0c\u800c VGKC \u6297\u4f53\u8111\u708e\uff08\u6216\u5176\u4ed6\u81ea\u8eab\u514d\u75ab\u6027\u8111\u708e\uff09\u7edd\u5927\u591a\u6570\u53ef\u6cbb\uff0c\u5c3d\u65e9\u884c\u6297\u4f53\u68c0\u6d4b\u6216\u53ef\u65e9\u671f\u8bca\u65ad\uff0c\u5c3d\u65e9\u5f00\u59cb\u514d\u75ab\u6291\u5236\u7597\u6cd5\u6216\u53ef\u964d\u4f4e\u81f4\u6b8b\u7387\u548c\u81f4\u6b7b\u7387\u3002<\/p>\n

\u4e34\u5e8a\u4e0a\u78b0\u5230\u5feb\u901f\u8fdb\u5c55\u6027\u75f4\u5446\u7684\u60a3\u8005\uff0c\u5728\u8bca\u65ad CJD \u524d\u9700\u8003\u8651\u5e76\u6392\u9664\u53ef\u6cbb\u6027\u75be\u75c5\uff0c\u4f8b\u5982\u81ea\u8eab\u514d\u75ab\u6027\u8111\u708e\uff0c\u7279\u522b\u662f VGKC \u6297\u4f53\u8111\u708e\u3002\u8bca\u65ad CJD \u610f\u5473\u7740\u7ed9\u60a3\u8005\u5224\u4e86\u6b7b\u5211\uff0c\u56e0\u6b64\u4e00\u5b9a\u8981\u614e\u91cd\u3002\u5728\u5c1a\u4e0d\u80fd\u660e\u786e\u75c5\u56e0\u65f6\uff0c\u53ef\u8003\u8651\u7ecf\u9a8c\u6027\u5f00\u59cb\u4e00\u4e9b\u53ef\u6cbb\u6027\u9274\u522b\u75be\u75c5\u7684\u6cbb\u7597\uff0c\u56e0\u4e3a\u67d0\u4e9b\u53ef\u6cbb\u6027\u75f4\u5446\u65e9\u671f\u5e72\u9884\u53ef\u80fd\u6539\u5584\u60a3\u8005\u9884\u540e\u3002<\/p>\n

\u5bf9\u4e8e\u4efb\u4f55\u514d\u75ab\u6291\u5236\u6cbb\u7597\u65e0\u6548\u7684\u5feb\u901f\u8fdb\u5c55\u6027\u75f4\u5446\uff0c\u5373\u4fbf\u795e\u7ecf\u5143\u6297\u4f53\u9633\u6027\uff0c\u4e5f\u5e94\u91cd\u65b0\u8bc4\u4f30\u662f\u5426\u4e3a CJD\u3002\u9700\u590d\u67e5\u8111\u810a\u6db2\uff0c\u5934\u9885 MRI\uff0c\u8111\u7535\u56fe\uff0c\u751a\u81f3\u6d3b\u68c0\u660e\u786e\u3002<\/p>\n

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\u6295\u7a3f\u53ca\u5408\u4f5c | wanghong@dxy.cn<\/span>
<\/span>\u9898\u56fe\u6765\u6e90| shutterstock<\/span><\/span><\/p>\n

\"\u5f02\u75c5\u540c\u8c61\uff1a\u96be\u4ee5\u9274\u522b\u7684\u81ea\u8eab\u514d\u75ab\u6027\u8111\u708e\u548c\u514b\u96c5\u75c5\"<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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1. Fermo OP, Izbudak I, Sutter R, Venkatesan A, Kaplan PW, Probasco JC.Autoimmune encephalitis mimicking Creutzfeldt-Jakob disease.Neurol Clin Pract. 2014 Dec;4(6):493-495.<\/span><\/p>\n

2. Yoo JY, Hirsch LJ.Limbic encephalitis associated with anti-voltage-gated potassium channel complex antibodies mimicking Creutzfeldt-Jakob disease.JAMA Neurol. 2014 Jan;71(1):79-82.<\/span><\/p>\n

3. Zuhorn F, H\u00fcbenthal A, Rogalewski A, Dogan Onugoren M, Glatzel M, Bien CG, Sch\u00e4bitz WR.Creutzfeldt-Jakob disease mimicking autoimmune encephalitis with CASPR2 antibodies.BMC Neurol. 2014 Nov 30;14:227.<\/span><\/p>\n

4. Newey CR, Appleby BS, Shook S, Sarwal A.Patient With voltage-gated potassium-channel (VGKC) limbic encephalitis found to have Creutzfeldt-Jakob disease (CJD) at autopsy.J Neuropsychiatry Clin Neurosci. 2013 Summer;25(3):E05-7.<\/span><\/p>\n

5. Geschwind MD, Tan KM, Lennon VA, Barajas RF Jr, Haman A, Klein CJ, Josephson SA, Pittock SJ.Voltage-gated potassium channel autoimmunity mimicking creutzfeldt-jakob disease.Arch Neurol. 2008 Oct;65(10):1341-6.<\/span><\/p>\n

6. Maat P, de Beukelaar JW, Jansen C, Schuur M, van Duijn CM, van Coevorden MH, de Graaff E, Titulaer M, Rozemuller AJ, Sillevis Smitt P.Pathologically confirmed autoimmune encephalitis in suspected Creutzfeldt-Jakob disease.Neurol Neuroimmunol Neuroinflamm. 2015 Nov 12;2(6):e178.<\/span><\/p>\n

7. Rossi M, Mead S, Collinge J, Rudge P, Vincent A.Neuronal antibodies in patients with suspected or confirmed sporadic Creutzfeldt-Jakob disease.J Neurol Neurosurg Psychiatry. 2015 Jun;86(6):692-4.<\/span><\/p>\n

8. Grau-Rivera O, S\u00e1nchez-Valle R, Saiz A, Molinuevo JL, Bernab\u00e9 R, Munteis E, Pujadas F, Salvador A, Saura J, Ugarte A, Titulaer M, Dalmau J, Graus F.Determination of neuronal antibodies in suspected and define Creutzfeldt-Jakob disease.JAMA Neurol. 2014 Jan;71(1):74-8.<\/span><\/p>\n

9. Chen Y, Xing XW, Zhang JT, Wang RX, Zhao W, Tan QC, Liu RZ, Wang XQ, Huang XS, Yu SY.Autoimmune encephalitis mimicking sporadic Creutzfeldt-Jakob disease: A retrospective study.J Neuroimmunol. 2016 Jun 15;295-296:1-8.<\/span><\/p>\n<\/section>\n<\/section>\n


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