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首页> 外文期刊>Journal of neurology >Different routes of heroin intake cause various heroin-induced leukoencephalopathies
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Different routes of heroin intake cause various heroin-induced leukoencephalopathies

机译：不同的海洛因摄入量导致各种海洛因诱导的白细胞病

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ObjectiveToxic leukoencephalopathy is a rare but critical neurological disorder in heroin abusers. Our aim is to compare the clinical manifestations, brain MRIs and prognoses of heroin-induced leukoencephalopathy by different intake routes.MethodsWe present two patients with toxic leukoencephalopathy caused by intravenous (IV) injection of heroin and 48 additional cases from systematic reviews of the literature published between 1994 and 2018.ResultsAmong the 50 heroin abusers who developed leukoencephalopathy, inhalation was the most popular route (60%), followed by IV injection (30%) and snorting (10%). Mental changes, mutism and urine/fecal incontinence were the major symptoms in patients who IV injected heroin, while cerebellar ataxia and dysarthria were more common among those who inhaled heroin. Delayed-onset encephalopathy uniquely occurred in those who IV injected heroin, whereas progressive encephalopathy was more commonly observed in those who inhaled heroin. Clinical improvement was observed in 60% of patients, the overall mortality rate was 12%, and higher mortality was observed in patients who used the inhalation route (16.7%). The hallmarks on the MRIs of those who inhaled heroin were posterior to anterior involvement of the cerebral white matter and lesions in the posterior limbs of the internal capsules, cerebellum and brainstem. In contrast, those who IV injected heroin had more frequent lesions in the subcortical U fibers and the genu of the internal capsules.ConclusionThese data could help physicians make an early diagnosis and predict prognosis and suggest that prompt antioxidative or symptomatic treatments might reduce the long-term consequences and mortality of heroin-induced leukoencephalopathy.
机译：客观的白细胞病是海洛因滥用者中罕见但批判性的神经障碍。我们的宗旨是通过不同的进气路线比较海洛因诱导的白细胞病症的临床表现，脑部麦菌和预后。甲基丁德目前两名患有静脉注射（IV）注射海洛因引起的有毒白血病的患者，并出版了48名文献的系统审查48例在1994年至2018年期间。鉴化了50名海洛因滥用者，他们开发了白细胞病，吸入是最受欢迎的路线（60％），其次是IV注射（30％）并哼（10％）。精神变化，百变和尿液/粪便尿失禁是IV注射海洛因的患者的主要症状，而小脑共济失调和讨厌的患者在吸入海洛因的人中更为常见。延迟发病的脑病唯一发生在IV注射海洛因的人中，而进步性脑病在吸入海洛因的人中更常见。在60％的患者中观察到临床改善，总死亡率为12％，在使用吸入路线的患者中观察到更高的死亡率（16.7％）。吸入海洛因的人员的标志是后脑白质和病变在内胶囊，小脑和脑干的后肢的前提下的前提。相比之下，IV注射海洛因的人在皮下U纤维中更频繁的病变和内部胶囊。结论数据可以帮助医生进行早期诊断和预测预后，并提示促进抗氧化或症状药物可能会减少长期抗氧化或症状药物。海洛因诱导的白细胞病变的一期后果和死亡率。

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