【摘要】 目的总结焦磷酸盐沉积症腰椎病变的临床特点以提高该病的诊治水平。方法分析11例腰椎焦磷酸盐沉积症患者的临床资料,总结其临床特点。结果 11例患者男4例、女7例,年龄(68.9±8.6)岁,病程6个月(5 d～10年)。11例患者均出现腰痛、下肢放射痛、行走困难及下肢触觉减弱、踇趾背伸力减弱。7例患者血白细胞高于9.5×109/L;CT检查示10例患者病变区在腰骶节段,可见椎间盘突出、钙化。术中可见11例的病变组织呈灰褐色砂砾样物质沉积及纤维环、黄韧带钙化,病理学检查均示焦磷酸盐沉积,偏振光镜下见不折光三斜晶体。结论焦磷酸盐沉积症可导致腰椎间盘突出,CT检查所示椎间盘改变有助于提高诊断率,病理检查示焦磷酸盐沉积可明确诊断。更多还原

【Abstract】 Objective To summarize the clinical features of lumbar spinal lesions in patients with calcium pyrophosphate deposition disease( CPDD), aiming to improve the diagnosis and treatment of CPDD.Methods Clinical data and characteristics of 11 CPDD patients were analyzed and summarized. Results Among 11 CPDD patients, 4 cases were male and 7 female, aged(68.9±8.6) years on average, with a course of disease of 6 months(range: 5 d-10 years). All 11 patients suffered from low back pain, radiating pain of the lower limbs, walking difficulty, hypopselaphesia of the lower limbs and weakening dorsiflexion of the tarsus. The white blood cell count was higher than 9.5×10~9/L in 7 patients. CT scan demonstrated that the lesions were detected in the lumbosacral segment of 10 patients, accompanied with lumbar disc herniation and calcification. Intraoperatively, grayish-brown gravel-like deposits, fibrous ring and calcified ligamentum flavum were observed. Pathological examination revealed the pyrophosphate deposits. Non-refracting triclinic crystals were found under the polarized light microscope. Conclusions CPDD can lead to lumbar disc herniation. CT scan of the lumbar disc lesions can improve the diagnostic rate of CPDD. Pathological examination of the pyrophosphate deposition can confirm the diagnosis.更多还原