临床荟萃

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非酮症高血糖相关性舞蹈症临床特征分析

  

  1. 天津市第一中心医院 内分泌科,天津  300192
  • 出版日期:2019-10-20 发布日期:2019-12-09
  • 通讯作者: 江霞,Email: jiangxia9698@126.com

Clinical characteristics of hemichorea associated with nonketotic hyperglycaemia

  1. Department of Endocrinology,  Tianjin First Central Hosptial,  Tianjin 300192,  China
  • Online:2019-10-20 Published:2019-12-09
  • Contact: Corresponding author: Jiang Xia, Email: jiangxia9698@126.com

摘要: 目的  总结非酮症高血糖相关性舞蹈症患者的临床特征、影像学表现,探讨该症的可能发病机制及诊治方法。方法  回顾性分析我院近期收治的3例非酮症高血糖相关性舞蹈症患者病例资料,此3例患者分别就诊于我院内分泌科、神经内科、神经外科并分别收入院治疗,同时查阅国内外相关文献进行学习。结果  非酮症高血糖相关性舞蹈症通常表现为非酮症性高血糖、偏侧舞蹈症以及头MRI或CT典型的影像学表现三联征,但表现不尽相同,影像学特征也可出现差异,临床呈现多样化趋势。对3例患者均给予降糖,联合或不联合控制舞蹈症症状药物后,均好转。结论  快速的判断及识别出此症是重中之重,及时而正确的调控血糖是治疗的关键,必要时应用多巴胺受体拮抗剂联合治疗可加速患者临床症状的好转,此症预后良好。

关键词: 高血糖症, 舞蹈症, 糖尿病,  , 2型

Abstract: Objective  To summarize the clinical features and imaging findings of patients with hemichorea associated with nonketotic hyperglycaemia(HCNH),  and to explore the possible pathogenesis,  diagnosis and treatment of the disease. Methods  Retrospective analysis was performed on the case data of  three patients with HCNH admitted to the hospital recently. The three patients were treated in the department of endocrinology,  neurology and  of neurosurgery in our hospital, respectively. Meanwhile,  relevant literature were consulted for further study. Results  HCNH usually presented as a triad of nonketone hyperglycemia,  lateral chorea,  and typical imaging manifestations of head MRI or CT,  but the manifestations were not the same,  and imaging features were also  different.  And the disease also presented a diversified trend in clinical practice. All three patients were given glucoselowering drugs,  and improved with or without combination of drugs to control symptoms of chorea. Conclusion  Fast judgement and recognition of the disease is a top priority,  timely and correct control of blood glucose is the key to the treatment. When necessary,  dopamine receptor antagonists with combination therapy in the patients can accelerate improvement of the clinical symptoms. The disease prognosis is good.

Key words: hyperglycemia;chorea, diabetes mellitus, type 2