【摘要】 目的对SCD个案报道文献回顾性研究,为SCD的预防、诊断、治疗提供理论依据。方法在Pub Med数据库中检索脊髓亚急性联合变性相关词条,获取2019年3月2日-1990年1月1日发表文章526篇,最终255个案纳入研究。结果 SCD常见病因为维生素B12缺乏（128例）、吸入N₂O（70例）、铜缺乏（31例）。该病多见于中年人（44.5±19.9）岁,病程相对较长（36.5±85.1） w。患者以肢体感觉减退最常见（73.3%）,其次为共济障碍（61.6%）,四肢运动系统也可受累（35.3%）。自主神经系统、颅神经、意识障碍、认知障碍少见。SCD患者常合并巨细胞性贫血（72.5%）和高同型半胱氨酸血症（80.9%）。脊髓MR可见后索异常信号影（82.9%）,以颈髓最多见。结论维生素B12缺乏是成人SCD最常见病因,青年人应该注意N₂O滥用可能。患者多表现为周围神经系统损害表现,以感觉系统受损多见,脊髓MR后索异常信号影对诊断具有特异性。大部分SCD患者经治疗后预后良好。更多还原

【Abstract】 Objective This study retrospectively analyzed reported cases of subacute combined degeneration of spinal cords（ SCD）. The purpose of this study was to provide theoretical basis for the prevention,diagnosis,treatment and research of SCD. Methods We searched the Pub Med database for terms related to subacute combined degeneration of spinal cords from March 2,2019 to January 1,1990. 255 cases were finally included in the study. Results The common causes of SCD were Vitamin B12 deficiency（ 128 cases）,inhaled N₂O（ 70 cases） and copper deficiency（ 31 cases）. The disease usually happened on middle-ager（ 44. 5 ± 19. 9） years old. The course of the disease is relatively long（ 36. 5 ± 85. 1） weeks. Limbs hypoesthesia was the most common symptom（ 73. 3%）,followed by ataxia（ 61. 6%）,and limb motor system could also be involved（ 35. 3%）. Autonomic nervous system,cranial nerve,consciousness disorder and cognitive disorder are rare. The patients were often complicated with giant cell anemia（ 72. 5%） and hyperhomocysteinemia（ 80. 9%）. Spinal cord MR could show abnormal signal shadow in posterior cord（ 82. 9%）,most of which occurred in cervical cord. Conclusion Vitamin B12 deficiency was the most common cause of SCD in adults and N₂O abuse must be paid attention in young people. Most patients of SCD showed peripheral nervous system damage that sensory system damage is common. Abnormal signal shadow in posterior cord of spinal MR was specific for the diagnosis of SCD. Most patients with SCD have a good prognosis after treatment.更多还原