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目的:研究钩端螺旋体L型脑动脉炎发病机制,诊断及治疗:方法:对患者做钩体MAT检测,钩体L型培养,头颅CT扫描,结合文献分析总结。结果:本病多发生青少年,有钩体感染史,出现脑血管病变体征,其中偏瘫型25例,双偏瘫型8例,其它类11例。血和CSF钩体MAT(+)分别是87.5％(35/40)和72％(18/25)钩体L型培养(+)59.5％(44/74)。头颅CT显示梗塞灶27例,出血灶2例。青霉素等药治疗有效。结论:本病的发生可能与钩体L型直接损伤脑血管密切相关,根据病史,体征,钩体L型培养,头颅CT扫描进行诊断和鉴别诊断。青霉素、甲哨哒唑治疗可改善病情。
OBJECTIVE: To study the pathogenesis, diagnosis and treatment of leptospiral L-type arteritis: Method: MAT test, L-type culture and cranial CT scan were performed on the patients. Results: The disease occurred in adolescents, the history of infection with hook body, signs of cerebrovascular disease, including 25 cases of hemiplegia, bipolar hemiplegia in 8 cases, other 11 cases. MAT (+) of blood and CSF hooks were 87.5% (35/40) and 72% (18/25) respectively. Lactation (+) 59.5% (44/74). Head CT showed 27 cases of infarction, hemorrhage in 2 cases. Penicillin and other drug treatment effective. Conclusion: The occurrence of this disease may be closely related to the L type direct injury of cerebrovascular. According to the history, signs, L type culture and cranial CT scan, the diagnosis and differential diagnosis are made. Penicillin, a sentinel treatment can improve the condition.