【摘要】 目的　研究烫吸海洛因蒸汽引起海绵状白质脑病的临床表现及影像学特征 ,探讨吸毒方式与病理改变的关系。方法　对 2例烫吸海洛因引起的海绵状白质脑病的患者进行了临床和 MRI观察 ,复习中外文献 ,对该病的临床表现、影像学特征、病理组织改变、吸毒方式与病理机制之间的关系进行了总结与讨论。结果　 2例患者均采用烫吸的方式摄入海洛因 ,时间为 1.5年、8年 ,均在戒毒数日后发病 ,以小脑性共济失调、智力减退为主要临床表现。MRI显示对称性小脑齿状核、双大脑半球半卵圆中心、胼胝体压部、内囊后肢、内侧丘系、红核、黑质、脑桥长 T1 T2 信号改变 ,给予地塞米松、脑多肽、胞二磷胆碱、B族维生素、高压氧、低能量激光血疗等治疗有近期疗效。结合文献资料显示本病可能与海洛因的烫吸方式有关 ,提出突然戒断与发病的可能关系。结论　烫吸海洛因引起海绵状白质脑病临床表现、影像学改变具有特征性 ,从而使本病能够得到早期确诊更多还原

【Abstract】 Objective To study the characteristics of clinical manifestations and MRI imaging of spongiform leucoencephalopathy after inhaling heroin vapour, to discuss the relationship between the way of ingestion and pathological findings. Methods Two patients with spongiform leucoencephalopathy after inhaling heroin vapour were observed in aspects of clinical manifestations and MRI imaging. Through reviewing the published literatures, clinical manifestations , MRI imaging characteristics, pathological changes, the way of ingestion were summarized and discussed. Results Two patients had the history of inhaling heroin vapour for 1.5 and 8 years respectively , and presented after some days of heroin withdrawal. The main symptoms were cerebellar antaxia and bradyphrenia. MRI revealed symmetrical hyperintensive lesions of cerebellar dentatum, centrum semiovale , splenium of corpus callosum, internal capsule, medial lemniscus, red nucleus, black substance, and pons. The patients were treated with dexamethasone, cerebral polypeptide, cytidine diphosphate choline, hyperbaric oxygen and low power He Ne laser intravascular irradiation, etc. The recent recovery was observed. With references it was suggested that this disease maybe related to the way of inhaling heroin vapour, and the presence maybe related to the abrupt abstinence. Conclusion Spongiform leucoencephalopathy after inhaling heroin vapour has its own characteristics of clinical manifestations and MRI imaging, therefore it is available to be early diagnosed.更多还原