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3.按病因分类（1）原发性抽动障碍：包括小儿急性短暂性抽动，慢性抽动障碍，TS，成人起病的抽动障碍，老年抽动障碍等。 | [
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"id": 2,
"entity": "TS",
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"entity": "成人起病的抽动障碍",
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"entity": "老年抽动障碍",
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（2）继发性抽动障碍：是与各种神经疾病相关联，分为以下几种类型。 | [
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1）遗传性：包括染色体异常（如唐氏综合征，脆性X综合征及其他染色体病），亨廷顿舞蹈病，肌张力障碍（如Meige综合征），Hyperekplexias等。 | [
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"entity": "脆性X综合征",
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"entity": "其他染色体病",
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"label": "dis"
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"entity": "亨廷顿舞蹈病",
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"id": 4,
"entity": "肌张力障碍",
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"label": "dis"
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"id": 5,
"entity": "Meige综合征",
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"label": "dis"
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"id": 6,
"entity": "Hyperekplexias",
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"label": "dis"
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2）发育性：包括Rett综合征，静止性（static）脑病（如缺氧等），全面发育延迟等。 | [
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"entity": "全面发育延迟",
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3）变性性：包括神经棘红细胞病，进行性核上性麻痹等。 | [
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4）精神性：包括精神分裂症，OCD等。 | [
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5）中毒-代谢性：包括一氧化碳中毒，低血糖等。 | [
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"entity": "低血糖",
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"label": "dis"
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6）药物性：包括精神抑制药（致迟发性抽动），兴奋剂，抗惊厥药，左旋多巴等。 | [
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7）感染性：包括风湿性舞蹈病，脑炎，脑炎后帕金森综合征，克-雅病，Rubella综合征等。 | [
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"entity": "克-雅病",
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"entity": "Rubella综合征",
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8）习惯性身体动作（habitualbodymanipulations）：包括吸吮手指，咬指甲，擦眼睛，触摸耳朵，挖鼻孔，触摸外生殖器等。 | [
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"entity": "挖鼻孔",
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"entity": "触摸外生殖器",
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9）刻板动作：包括点头或击头，摇动身体，手臂抽动（armjerking）等。 | [
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（1）原发性抽动障碍：包括TS、慢性复杂运动抽动障碍、慢性复杂发声抽动障碍、慢性单纯运动抽动障碍、慢性单纯发声抽动障碍以及短暂性抽动障碍。 | [
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"entity": "短暂性抽动障碍",
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] |
（2）继发性抽动障碍：很多神经科疾病如亨廷顿舞蹈病、神经棘红细胞病、扭转痉挛、染色体异常和其他遗传性疾病等都可引起抽动，这些情况属于继发性抽动障碍。 | [
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"entity": "其他遗传性疾病",
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"entity": "继发性抽动障碍",
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与原发性抽动障碍不同的是，这些继发性抽动障碍伴发其他运动障碍，如舞蹈和肌张力障碍等。 | [
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"entity": "舞蹈和肌张力障碍",
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此外，获得性抽动障碍包括药物性（左旋多巴、抗精神病药物以及抗惊厥药）、外伤引发的抽动障碍，脑炎、风湿性舞蹈病以及皮质纹状体脊髓变性等感染性疾病，发育异常，精神发育异常，孤独症，卒中（中风），累及基底神经节的变性病（如帕金森病和进行性核上性麻痹），中毒（如一氧化碳中毒）。 | [
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"entity": "风湿性舞蹈病",
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{
"id": 7,
"entity": "皮质纹状体脊髓变性",
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"label": "dis"
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"entity": "发育异常",
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"entity": "精神发育异常",
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{
"id": 10,
"entity": "孤独症",
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"label": "sym"
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{
"id": 11,
"entity": "卒中（中风）",
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"label": "sym"
},
{
"id": 12,
"entity": "累及基底神经节的变性病",
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"end_offset": 106,
"label": "dis"
},
{
"id": 13,
"entity": "帕金森病",
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"end_offset": 112,
"label": "dis"
},
{
"id": 14,
"entity": "进行性核上性麻痹",
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"label": "dis"
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{
"id": 15,
"entity": "一氧化碳中毒",
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"label": "sym"
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] |
5.Weingarten分类Weingarten于1968年按病因、疾病范围和严重程度将抽动障碍分为以下四型。 | [
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（1）无器质性病因的抽动障碍：2岁儿童就可起病，6～12岁明显增多，以后随年龄增长而发病率减少。 | [
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在30岁以前，全部抽动障碍的34左右都属于无器质性病因的抽动障碍。 | [
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在40岁以后，本组抽动障碍则占全部抽动障碍病人总数的12左右。 | [
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本组抽动常累及面部和颈部，使得病人有种不愉快的感觉。 | [
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在面部的抽动可有眼部抽动（瞬目抽动）、耳朵抽动、鼻部抽动、唇抽动、舌抽动以及喉头抽动等形式，大多较轻，呈单一性，病人不一定就医。 | [
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"entity": "舌抽动",
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"entity": "喉头抽动",
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颈部和胸部的抽动可有扭转样发作。 | [
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] |
肩、臂、手的抽动常与面部抽动合并发生，但也有单独发生，呈现上臂突然一个甩动。 | [
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"entity": "面部",
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] |
下肢抽动十分少见，偶尔病人发作时的表现为行走中突然跳一下。 | [
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喉部的发声抽动表现为喉中有“哼、噢”等声音。 | [
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内脏的抽动相当罕见，有食管和呼吸道的抽动。 | [
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"entity": "食管和呼吸道的抽动",
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（2）TS：系抽动障碍分类中病情相对较重的一型。 | [
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（3）由锥体外系器质性疾病等原因引起的继发性抽动障碍。 | [
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] |
1）纹状体性抽动（striataltics）：由各种原因的纹状体损害造成。 | [
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如脑炎后（如昏睡性脑炎）、神经棘红细胞病、脑血管病、颅脑外伤、脑肿瘤、脑软化灶、中毒性损害（一氧化碳中毒和锰中毒）以及神经梅毒等造成纹状体损害时均可出现抽动样运动障碍（tic-likedyskinesias）。 | [
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"entity": "脑肿瘤",
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"id": 6,
"entity": "脑软化灶",
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"entity": "中毒性损害",
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{
"id": 8,
"entity": "一氧化碳中毒",
"start_offset": 46,
"end_offset": 52,
"label": "dis"
},
{
"id": 9,
"entity": "锰中毒",
"start_offset": 53,
"end_offset": 56,
"label": "dis"
},
{
"id": 10,
"entity": "神经梅毒",
"start_offset": 59,
"end_offset": 63,
"label": "dis"
},
{
"id": 11,
"entity": "抽动样运动障碍",
"start_offset": 76,
"end_offset": 83,
"label": "dis"
}
] |
2）斜颈：一般认为斜颈为锥体外系疾病，但功能性反射性抽动（reflextic）导致颈部肌肉一侧的抽动，也可产生斜颈。 | [
{
"id": 0,
"entity": "锥体外系疾病",
"start_offset": 12,
"end_offset": 18,
"label": "dis"
},
{
"id": 1,
"entity": "功能性反射性抽动",
"start_offset": 20,
"end_offset": 28,
"label": "dis"
},
{
"id": 2,
"entity": "reflextic",
"start_offset": 29,
"end_offset": 38,
"label": "dis"
}
] |
吩噻嗪（phenothiazine）治疗精神病时的副作用可为抽动样多动。 | [
{
"id": 0,
"entity": "吩噻嗪",
"start_offset": 0,
"end_offset": 3,
"label": "dru"
}
] |
左旋多巴及卡马西平等药物都可引起抽动样多动。 | [
{
"id": 0,
"entity": "左旋多巴",
"start_offset": 0,
"end_offset": 4,
"label": "dru"
},
{
"id": 1,
"entity": "卡马西平",
"start_offset": 5,
"end_offset": 9,
"label": "dru"
}
] |
4）头颈部疾患所致的继发性抽动障碍：该型包括反射性抽动（reflextic）、偏侧面肌痉挛（hemifacialspasms）和面轻瘫后抽动（ticfollowingfacialparesis），与功能性抽动障碍的区别在于它们只累及面神经支配的肌群，而不影响颈、肩和肢体的肌群。 | [
{
"id": 0,
"entity": "继发性抽动障碍",
"start_offset": 10,
"end_offset": 17,
"label": "dis"
},
{
"id": 1,
"entity": "反射性抽动",
"start_offset": 22,
"end_offset": 27,
"label": "dis"
},
{
"id": 2,
"entity": "偏侧面肌痉挛",
"start_offset": 39,
"end_offset": 45,
"label": "sym"
},
{
"id": 3,
"entity": "hemifacialspasms",
"start_offset": 46,
"end_offset": 62,
"label": "sym"
},
{
"id": 4,
"entity": "面轻瘫后抽动",
"start_offset": 64,
"end_offset": 70,
"label": "sym"
},
{
"id": 5,
"entity": "功能性抽动障碍",
"start_offset": 99,
"end_offset": 106,
"label": "dis"
},
{
"id": 6,
"entity": "颈",
"start_offset": 129,
"end_offset": 130,
"label": "bod"
},
{
"id": 7,
"entity": "肩",
"start_offset": 131,
"end_offset": 132,
"label": "bod"
},
{
"id": 8,
"entity": "肢体",
"start_offset": 133,
"end_offset": 135,
"label": "bod"
}
] |
抽动成丛集性发作，每一次发作持续时间不等（半秒钟到1min），总共持续数秒钟到数分钟。 | [
{
"id": 0,
"entity": "每一次发作持续时间不等",
"start_offset": 9,
"end_offset": 20,
"label": "sym"
},
{
"id": 1,
"entity": "总共持续数秒钟到数分钟",
"start_offset": 31,
"end_offset": 42,
"label": "sym"
}
] |
通常在睡眠时抽动也不消失，甚至在麻醉的情况下抽动也不消失，且抽动难以通过主观意志来控制。 | [
{
"id": 0,
"entity": "睡眠时抽动也不消失",
"start_offset": 3,
"end_offset": 12,
"label": "sym"
}
] |
治疗上，传统的神经安定类药物无效，可局部注射肉毒杆菌毒素。 | [
{
"id": 0,
"entity": "注射",
"start_offset": 20,
"end_offset": 22,
"label": "pro"
},
{
"id": 1,
"entity": "肉毒杆菌毒素",
"start_offset": 22,
"end_offset": 28,
"label": "dru"
}
] |
6.Robertson分类1988年Robertson等提出，从临床的角度可将抽动障碍分为以下三类。 | [
{
"id": 0,
"entity": "Robertson",
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"end_offset": 11,
"label": "dis"
}
] |
（1）单纯性抽动障碍：临床上主要表现为或几乎表现为运动或发声抽动者。 | [
{
"id": 0,
"entity": "单纯性抽动障碍",
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"label": "dis"
},
{
"id": 1,
"entity": "运动或发声抽动者",
"start_offset": 25,
"end_offset": 33,
"label": "sym"
}
] |
（2）全面发展的抽动障碍：除多发性抽动障碍外，可有秽语、模仿或应声性发声或回文现象（paliphenomena，即语句既顺着说又倒着说）。 | [
{
"id": 0,
"entity": "全面发展的抽动障碍",
"start_offset": 3,
"end_offset": 12,
"label": "dis"
},
{
"id": 1,
"entity": "多发性抽动障碍",
"start_offset": 14,
"end_offset": 21,
"label": "dis"
},
{
"id": 2,
"entity": "秽语",
"start_offset": 25,
"end_offset": 27,
"label": "sym"
},
{
"id": 3,
"entity": "模仿",
"start_offset": 28,
"end_offset": 30,
"label": "sym"
},
{
"id": 4,
"entity": "应声性发声",
"start_offset": 31,
"end_offset": 36,
"label": "sym"
},
{
"id": 5,
"entity": "回文现象",
"start_offset": 37,
"end_offset": 41,
"label": "sym"
}
] |
（3）抽动障碍附加症（ticdisordersplus，TD+<sup>）：指除有抽动障碍外，还伴有ADHD、强迫-冲动症状（OCS）强迫-冲动行为（OCB）或自伤行为等共患病症；抽动障碍伴有抑郁、焦虑、性格改变、社会和学校生活适应困难，甚至有反社会行为者，也可列入此类。 | [
{
"id": 0,
"entity": "抽动障碍附加症",
"start_offset": 3,
"end_offset": 10,
"label": "dis"
},
{
"id": 1,
"entity": "抽动障碍",
"start_offset": 41,
"end_offset": 45,
"label": "dis"
},
{
"id": 2,
"entity": "ADHD",
"start_offset": 50,
"end_offset": 54,
"label": "dis"
},
{
"id": 3,
"entity": "强迫-冲动症状",
"start_offset": 55,
"end_offset": 62,
"label": "sym"
},
{
"id": 4,
"entity": "强迫-冲动行为",
"start_offset": 67,
"end_offset": 74,
"label": "sym"
},
{
"id": 5,
"entity": "自伤行为",
"start_offset": 80,
"end_offset": 84,
"label": "sym"
},
{
"id": 6,
"entity": "抽动障碍",
"start_offset": 90,
"end_offset": 94,
"label": "dis"
},
{
"id": 7,
"entity": "抑郁",
"start_offset": 96,
"end_offset": 98,
"label": "sym"
},
{
"id": 8,
"entity": "焦虑",
"start_offset": 99,
"end_offset": 101,
"label": "sym"
},
{
"id": 9,
"entity": "性格改变",
"start_offset": 102,
"end_offset": 106,
"label": "sym"
},
{
"id": 10,
"entity": "社会和学校生活适应困难",
"start_offset": 107,
"end_offset": 118,
"label": "sym"
}
] |
二、梦魇梦魇即做噩梦，它常常使睡眠者从REM睡眠中醒来，影响REM睡眠。 | [
{
"id": 0,
"entity": "梦魇",
"start_offset": 3,
"end_offset": 5,
"label": "dis"
},
{
"id": 1,
"entity": "梦魇",
"start_offset": 5,
"end_offset": 7,
"label": "dis"
},
{
"id": 2,
"entity": "噩梦",
"start_offset": 9,
"end_offset": 11,
"label": "dis"
}
] |
有关梦魇的发生率各研究的报道不一致。 | [
{
"id": 0,
"entity": "梦魇",
"start_offset": 2,
"end_offset": 4,
"label": "dis"
}
] |
3～5岁的儿童中10%～50%有相当多的梦魇，约75%的小儿在童年期至少有一次或几次的梦魇，约50%的成人承认至少有过一次梦魇。 | [
{
"id": 0,
"entity": "梦魇",
"start_offset": 20,
"end_offset": 22,
"label": "dis"
},
{
"id": 1,
"entity": "梦魇",
"start_offset": 43,
"end_offset": 45,
"label": "dis"
},
{
"id": 2,
"entity": "梦魇",
"start_offset": 61,
"end_offset": 63,
"label": "dis"
}
] |
可能有1%的成人有每周一次或一次以上的频繁梦魇。 | [
{
"id": 0,
"entity": "梦魇",
"start_offset": 21,
"end_offset": 23,
"label": "dis"
}
] |
梦魇通常起始于3～6岁，但可发生于任何年龄。 | [
{
"id": 0,
"entity": "梦魇",
"start_offset": 0,
"end_offset": 2,
"label": "dis"
}
] |
有研究表明，频繁发作、持续终身的梦魇有家族倾向。 | [
{
"id": 0,
"entity": "梦魇",
"start_offset": 16,
"end_offset": 18,
"label": "dis"
}
] |
【病因及易感因素】梦魇的病因不明。 | [
{
"id": 0,
"entity": "梦魇",
"start_offset": 9,
"end_offset": 11,
"label": "dis"
}
] |
【临床表现】梦魇的总是长而复杂的梦，从开始到结束其内容越来越恐怖。 | [
{
"id": 0,
"entity": "梦魇",
"start_offset": 6,
"end_offset": 8,
"label": "dis"
}
] |
觉醒发生于REM睡眠期，有时不是立即觉醒，而是随之回忆一个非常恐怖的梦，但这种状况在梦魇中并不常见。 | [
{
"id": 0,
"entity": "梦魇",
"start_offset": 42,
"end_offset": 44,
"label": "dis"
}
] |
恐怖和焦虑是梦魇的主要成分。 | [
{
"id": 0,
"entity": "梦魇",
"start_offset": 6,
"end_offset": 8,
"label": "dis"
}
] |
梦魇时很少有讲话、尖叫、行走，这就有别于夜惊和REM睡眠行为障碍。 | [
{
"id": 0,
"entity": "梦魇",
"start_offset": 0,
"end_offset": 2,
"label": "dis"
},
{
"id": 1,
"entity": "讲话",
"start_offset": 6,
"end_offset": 8,
"label": "sym"
},
{
"id": 2,
"entity": "尖叫",
"start_offset": 9,
"end_offset": 11,
"label": "sym"
},
{
"id": 3,
"entity": "行走",
"start_offset": 12,
"end_offset": 14,
"label": "sym"
}
] |
父母常常在小儿2～3岁时就发现梦魇，但小儿只有在3～4岁才能描述恐怖的梦。 | [
{
"id": 0,
"entity": "梦魇",
"start_offset": 15,
"end_offset": 17,
"label": "dis"
}
] |
梦魇的发作次数常常在几个星期、几个月或几年后明显减少。 | [
{
"id": 0,
"entity": "梦魇",
"start_offset": 0,
"end_offset": 2,
"label": "dis"
}
] |
部分儿童的梦魇可持续到青春期甚至成人，这些个体通常成为频繁发作、持续终身的患者。 | [
{
"id": 0,
"entity": "梦魇",
"start_offset": 5,
"end_offset": 7,
"label": "dis"
}
] |
【诊断】（一）睡眠障碍的国际分型中梦魇的诊断标准1.至少有一次突然从睡眠中醒来，伴随极度的害怕、焦虑，感觉将有危害降临。 | [
{
"id": 0,
"entity": "梦魇",
"start_offset": 17,
"end_offset": 19,
"label": "dis"
},
{
"id": 1,
"entity": "至少有一次突然从睡眠中醒来",
"start_offset": 26,
"end_offset": 39,
"label": "sym"
},
{
"id": 2,
"entity": "伴随极度的害怕",
"start_offset": 40,
"end_offset": 47,
"label": "sym"
},
{
"id": 3,
"entity": "焦虑",
"start_offset": 48,
"end_offset": 50,
"label": "sym"
},
{
"id": 4,
"entity": "感觉将有危害降临",
"start_offset": 51,
"end_offset": 59,
"label": "sym"
}
] |
2.患者能立即回忆恐怖的梦境内容。 | [
{
"id": 0,
"entity": "能立即回忆恐怖的梦境内容",
"start_offset": 4,
"end_offset": 16,
"label": "sym"
}
] |
3.醒来后立即完全清醒，几乎没有混乱或迷惑。 | [
{
"id": 0,
"entity": "醒来后立即完全清醒",
"start_offset": 2,
"end_offset": 11,
"label": "sym"
},
{
"id": 1,
"entity": "没有混乱或迷惑",
"start_offset": 14,
"end_offset": 21,
"label": "sym"
}
] |
4.至少有以下一个相关特征（1）发作后继续睡眠，但并不是迅速入睡。 | [
{
"id": 0,
"entity": "发作后继续睡眠，但并不是迅速入睡",
"start_offset": 16,
"end_offset": 32,
"label": "sym"
}
] |
（2）发生于平时睡眠期的后1/2。 | [
{
"id": 0,
"entity": "发生于平时睡眠期的后1/2",
"start_offset": 3,
"end_offset": 16,
"label": "sym"
}
] |
5.PSG的特征（1）从已有持续10分钟以上的REM睡眠期突然醒来。 | [
{
"id": 0,
"entity": "从已有持续10分钟以上的REM睡眠期突然醒来",
"start_offset": 11,
"end_offset": 33,
"label": "sym"
}
] |
（2）发作时轻度心动过速和呼吸加快。 | [
{
"id": 0,
"entity": "发作时轻度心动过速和呼吸加快",
"start_offset": 3,
"end_offset": 17,
"label": "sym"
}
] |
（3）没有癫痫活动。 | [
{
"id": 0,
"entity": "没有癫痫活动",
"start_offset": 3,
"end_offset": 9,
"label": "sym"
}
] |
6.可以与其他的睡眠障碍，如夜惊和梦游并存。 | [
{
"id": 0,
"entity": "夜惊",
"start_offset": 14,
"end_offset": 16,
"label": "dis"
},
{
"id": 1,
"entity": "梦游",
"start_offset": 17,
"end_offset": 19,
"label": "dis"
}
] |
临床诊断梦魇至少符合上述标准的1～4项。 | [
{
"id": 0,
"entity": "梦魇",
"start_offset": 4,
"end_offset": 6,
"label": "dis"
}
] |
（二）梦魇根据其严重程度可分为三度1.轻度发作少于每周一次，没有心理社交功能损害的表现。 | [
{
"id": 0,
"entity": "梦魇",
"start_offset": 3,
"end_offset": 5,
"label": "dis"
},
{
"id": 1,
"entity": "发作少于每周一次，没有心理社交功能损害的表现",
"start_offset": 21,
"end_offset": 43,
"label": "sym"
}
] |
2.中度每周发作一次以上，但不是每夜发生，有轻度的心理社交损害的表现。 | [
{
"id": 0,
"entity": "每周发作一次以上，但不是每夜发生，有轻度的心理社交损害的表现",
"start_offset": 4,
"end_offset": 34,
"label": "sym"
}
] |
3.重度每夜发作，有中度或重度心理社交功能损害的表现。 | [
{
"id": 0,
"entity": "每夜发作，有中度或重度心理社交功能损害的表现",
"start_offset": 4,
"end_offset": 26,
"label": "sym"
}
] |
【鉴别诊断】（一）夜惊见表3-3。 | [
{
"id": 0,
"entity": "夜惊",
"start_offset": 9,
"end_offset": 11,
"label": "dis"
}
] |
表3-7夜惊和梦魇的鉴别诊断（二）REM睡眠行为障碍较常见于中年以上者，在REM睡眠期常有暴力的、暴发性的动作，但并不突然觉醒至完全清醒，较少有害怕和恐惧的表现，可见特征性的PSG。 | [
{
"id": 0,
"entity": "梦魇",
"start_offset": 7,
"end_offset": 9,
"label": "dis"
},
{
"id": 1,
"entity": "REM睡眠行为障碍",
"start_offset": 17,
"end_offset": 26,
"label": "dis"
},
{
"id": 2,
"entity": "在REM睡眠期常有暴力的、暴发性的动作",
"start_offset": 36,
"end_offset": 55,
"label": "sym"
},
{
"id": 3,
"entity": "但并不突然觉醒至完全清醒",
"start_offset": 56,
"end_offset": 68,
"label": "sym"
},
{
"id": 4,
"entity": "较少有害怕和恐惧的表现",
"start_offset": 69,
"end_offset": 80,
"label": "sym"
}
] |
【治疗】偶发梦魇无需特殊治疗。 | [
{
"id": 0,
"entity": "梦魇",
"start_offset": 6,
"end_offset": 8,
"label": "dis"
}
] |
第十节脊髓灰质炎脊髓灰质炎（poliomyelitis，简称灰髓炎）是由脊髓灰质炎病毒引起的急性神经系统传染病。 | [
{
"id": 0,
"entity": "脊髓灰质炎",
"start_offset": 3,
"end_offset": 8,
"label": "dis"
},
{
"id": 1,
"entity": "脊髓灰质炎",
"start_offset": 8,
"end_offset": 13,
"label": "dis"
},
{
"id": 2,
"entity": "poliomyelitis",
"start_offset": 14,
"end_offset": 27,
"label": "dis"
},
{
"id": 3,
"entity": "灰髓炎",
"start_offset": 30,
"end_offset": 33,
"label": "dis"
},
{
"id": 4,
"entity": "脊髓灰质炎病毒",
"start_offset": 36,
"end_offset": 43,
"label": "mic"
},
{
"id": 5,
"entity": "急性神经系统传染病",
"start_offset": 46,
"end_offset": 55,
"label": "dis"
}
] |
临床特征为分布不规则和轻重不等的弛缓性肌肉麻痹。 | [
{
"id": 0,
"entity": "肌肉",
"start_offset": 19,
"end_offset": 21,
"label": "bod"
},
{
"id": 1,
"entity": "分布不规则和轻重不等的弛缓性肌肉麻痹",
"start_offset": 5,
"end_offset": 23,
"label": "sym"
}
] |
重者可于急性期因呼吸、吞咽麻痹而死亡。 | [
{
"id": 0,
"entity": "呼吸、吞咽麻痹",
"start_offset": 8,
"end_offset": 15,
"label": "sym"
},
{
"id": 1,
"entity": "死亡",
"start_offset": 16,
"end_offset": 18,
"label": "sym"
}
] |
我国推行疫苗预防后发病率已大大下降。 | [
{
"id": 0,
"entity": "疫苗",
"start_offset": 4,
"end_offset": 6,
"label": "dru"
}
] |
【病原和流行病学】脊髓灰质炎病毒（poliovirus，简称灰髓炎病毒）为无包膜的单正链RNA病毒，属小RNA病毒科肠道病毒属。 | [
{
"id": 0,
"entity": "脊髓灰质炎病毒",
"start_offset": 9,
"end_offset": 16,
"label": "mic"
},
{
"id": 1,
"entity": "poliovirus",
"start_offset": 17,
"end_offset": 27,
"label": "mic"
},
{
"id": 2,
"entity": "灰髓炎病毒",
"start_offset": 30,
"end_offset": 35,
"label": "mic"
},
{
"id": 3,
"entity": "单正链RNA病毒",
"start_offset": 41,
"end_offset": 49,
"label": "mic"
},
{
"id": 4,
"entity": "小RNA病毒",
"start_offset": 51,
"end_offset": 57,
"label": "mic"
},
{
"id": 5,
"entity": "肠道病毒",
"start_offset": 58,
"end_offset": 62,
"label": "mic"
}
] |
3型病毒间无共同抗原，可分别感染人类而致病。 | [
{
"id": 0,
"entity": "3型病毒",
"start_offset": 0,
"end_offset": 4,
"label": "mic"
}
] |
病毒可在很多灵长类动物非神经组织的原代或传代细胞中增殖。 | [
{
"id": 0,
"entity": "病毒",
"start_offset": 0,
"end_offset": 2,
"label": "mic"
}
] |
病毒在外环境中较为稳定，在粪便中能存活6个月，生活污水中存活4个月。 | [
{
"id": 0,
"entity": "病毒",
"start_offset": 0,
"end_offset": 2,
"label": "mic"
},
{
"id": 1,
"entity": "粪便",
"start_offset": 13,
"end_offset": 15,
"label": "bod"
}
] |
紫外线、漂白粉、过氧化氢等氧化剂、高锰酸钾、甲醛、碘酊和升汞等均能杀灭之。 | [
{
"id": 0,
"entity": "过氧化氢",
"start_offset": 8,
"end_offset": 12,
"label": "dru"
},
{
"id": 1,
"entity": "氧化剂",
"start_offset": 13,
"end_offset": 16,
"label": "dru"
},
{
"id": 2,
"entity": "高锰酸钾",
"start_offset": 17,
"end_offset": 21,
"label": "dru"
},
{
"id": 3,
"entity": "甲醛",
"start_offset": 22,
"end_offset": 24,
"label": "dru"
},
{
"id": 4,
"entity": "碘酊",
"start_offset": 25,
"end_offset": 27,
"label": "dru"
},
{
"id": 5,
"entity": "升汞",
"start_offset": 28,
"end_offset": 30,
"label": "dru"
}
] |
在潜伏期末，患者从鼻咽分泌物和粪便中排出病毒。 | [
{
"id": 0,
"entity": "鼻咽分泌物",
"start_offset": 9,
"end_offset": 14,
"label": "bod"
},
{
"id": 1,
"entity": "粪便",
"start_offset": 15,
"end_offset": 17,
"label": "bod"
},
{
"id": 2,
"entity": "病毒",
"start_offset": 20,
"end_offset": 22,
"label": "mic"
}
] |
病毒在咽部存在时间一般不超过病后一周。 | [
{
"id": 0,
"entity": "病毒",
"start_offset": 0,
"end_offset": 2,
"label": "mic"
},
{
"id": 1,
"entity": "咽部",
"start_offset": 3,
"end_offset": 5,
"label": "bod"
}
] |
在粪便中排病毒时间较久，个别可长达3～4个月。 | [
{
"id": 0,
"entity": "粪便",
"start_offset": 1,
"end_offset": 3,
"label": "bod"
},
{
"id": 1,
"entity": "病毒",
"start_offset": 5,
"end_offset": 7,
"label": "mic"
}
] |
病毒污染用具、玩具、食物或水源，易感者接触或食用后获感染。 | [
{
"id": 0,
"entity": "病毒",
"start_offset": 0,
"end_offset": 2,
"label": "mic"
}
] |
1994年9月以来我国已成功阻断本土脊灰野病毒传播。 | [
{
"id": 0,
"entity": "脊灰野病毒",
"start_offset": 18,
"end_offset": 23,
"label": "mic"
}
] |
1995年11月～1996年4月发现4例输入野病毒病例和1999年1例输入野病毒病例后，未再发现野病毒传播的证据。 | [
{
"id": 0,
"entity": "野病毒",
"start_offset": 22,
"end_offset": 25,
"label": "mic"
},
{
"id": 1,
"entity": "野病毒",
"start_offset": 37,
"end_offset": 40,
"label": "mic"
},
{
"id": 2,
"entity": "野病毒",
"start_offset": 48,
"end_offset": 51,
"label": "mic"
}
] |
【发病机制和病理改变】病毒先在咽部和肠壁的淋巴组织内增殖。 | [
{
"id": 0,
"entity": "病毒",
"start_offset": 11,
"end_offset": 13,
"label": "mic"
},
{
"id": 1,
"entity": "咽部",
"start_offset": 15,
"end_offset": 17,
"label": "bod"
},
{
"id": 2,
"entity": "肠壁的淋巴组织",
"start_offset": 18,
"end_offset": 25,
"label": "bod"
}
] |
机体产生特异性抗体，可阻止病毒增殖，使感染中断，形成隐性感染。 | [
{
"id": 0,
"entity": "特异性抗体",
"start_offset": 4,
"end_offset": 9,
"label": "bod"
},
{
"id": 1,
"entity": "病毒",
"start_offset": 13,
"end_offset": 15,
"label": "mic"
},
{
"id": 2,
"entity": "感染",
"start_offset": 19,
"end_offset": 21,
"label": "sym"
}
] |
在少数患者，病毒可侵入血液循环，形成第一次病毒血症。 | [
{
"id": 0,
"entity": "病毒",
"start_offset": 6,
"end_offset": 8,
"label": "mic"
},
{
"id": 1,
"entity": "血液",
"start_offset": 11,
"end_offset": 13,
"label": "bod"
},
{
"id": 2,
"entity": "病毒血症",
"start_offset": 21,
"end_offset": 25,
"label": "dis"
}
] |
病毒到达全身淋巴组织和单核/吞噬细胞内继续增殖，再次入血（第二次病毒血症），此时患者有发热等前驱期症状。 | [
{
"id": 0,
"entity": "病毒",
"start_offset": 0,
"end_offset": 2,
"label": "mic"
},
{
"id": 1,
"entity": "淋巴组织",
"start_offset": 6,
"end_offset": 10,
"label": "bod"
},
{
"id": 2,
"entity": "单核/吞噬细胞",
"start_offset": 11,
"end_offset": 18,
"label": "bod"
},
{
"id": 3,
"entity": "血",
"start_offset": 27,
"end_offset": 28,
"label": "bod"
},
{
"id": 4,
"entity": "病毒血症",
"start_offset": 32,
"end_offset": 36,
"label": "dis"
},
{
"id": 5,
"entity": "发热",
"start_offset": 43,
"end_offset": 45,
"label": "sym"
}
] |
若产生的特异性抗体使疾病停止发展，则成为顿挫型。 | [
{
"id": 0,
"entity": "特异性抗体",
"start_offset": 4,
"end_offset": 9,
"label": "bod"
}
] |
如病毒量多、毒力大，透过血-脑屏障侵犯神经组织，产生瘫痪等症状；若病变轻微，可无瘫痪发生。 | [
{
"id": 0,
"entity": "病毒",
"start_offset": 1,
"end_offset": 3,
"label": "mic"
},
{
"id": 1,
"entity": "血-脑屏障",
"start_offset": 12,
"end_offset": 17,
"label": "bod"
},
{
"id": 2,
"entity": "神经组织",
"start_offset": 19,
"end_offset": 23,
"label": "bod"
},
{
"id": 3,
"entity": "瘫痪",
"start_offset": 26,
"end_offset": 28,
"label": "sym"
},
{
"id": 4,
"entity": "无瘫痪",
"start_offset": 39,
"end_offset": 42,
"label": "sym"
}
] |
病变以脊髓前角的运动神经元损害为主，尤以颈段和腰段损害多见。 | [
{
"id": 0,
"entity": "脊髓前角的运动神经元",
"start_offset": 3,
"end_offset": 13,
"label": "bod"
},
{
"id": 1,
"entity": "脊髓前角的运动神经元损害",
"start_offset": 3,
"end_offset": 15,
"label": "sym"
},
{
"id": 2,
"entity": "颈段",
"start_offset": 20,
"end_offset": 22,
"label": "bod"
},
{
"id": 3,
"entity": "腰段",
"start_offset": 23,
"end_offset": 25,
"label": "bod"
},
{
"id": 4,
"entity": "颈段和腰段损害",
"start_offset": 20,
"end_offset": 27,
"label": "sym"
}
] |
其次受损部位为脑干，病灶呈多发散在性，可见神经细胞内胞质染色质溶解，周围组织水肿、充血和血管周围炎性细胞浸润。 | [
{
"id": 0,
"entity": "脑干",
"start_offset": 7,
"end_offset": 9,
"label": "bod"
},
{
"id": 1,
"entity": "病灶呈多发散在性",
"start_offset": 10,
"end_offset": 18,
"label": "sym"
},
{
"id": 2,
"entity": "神经细胞内胞质染色质",
"start_offset": 21,
"end_offset": 31,
"label": "bod"
},
{
"id": 3,
"entity": "神经细胞内胞质染色质溶解",
"start_offset": 21,
"end_offset": 33,
"label": "sym"
},
{
"id": 4,
"entity": "周围组织水肿、充血",
"start_offset": 34,
"end_offset": 43,
"label": "sym"
},
{
"id": 5,
"entity": "血管",
"start_offset": 44,
"end_offset": 46,
"label": "bod"
},
{
"id": 6,
"entity": "炎性细胞",
"start_offset": 48,
"end_offset": 52,
"label": "bod"
},
{
"id": 7,
"entity": "血管周围炎性细胞浸润",
"start_offset": 44,
"end_offset": 54,
"label": "sym"
}
] |
严重者见神经细胞坏死和瘢痕形成。 | [
{
"id": 0,
"entity": "神经细胞",
"start_offset": 4,
"end_offset": 8,
"label": "bod"
},
{
"id": 1,
"entity": "神经细胞坏死和瘢痕形成",
"start_offset": 4,
"end_offset": 15,
"label": "sym"
}
] |
根据有无神经系统损害及损害程度和部位，又分为顿挫型、无瘫痪型、瘫痪型和脑型。 | [
{
"id": 0,
"entity": "神经系统",
"start_offset": 4,
"end_offset": 8,
"label": "bod"
},
{
"id": 1,
"entity": "神经系统损害",
"start_offset": 4,
"end_offset": 10,
"label": "sym"
},
{
"id": 2,
"entity": "无瘫痪",
"start_offset": 26,
"end_offset": 29,
"label": "sym"
},
{
"id": 3,
"entity": "瘫痪",
"start_offset": 31,
"end_offset": 33,
"label": "sym"
},
{
"id": 4,
"entity": "脑",
"start_offset": 35,
"end_offset": 36,
"label": "bod"
}
] |
典型病例的临床经过如下：（一）前驱期多有低热或中度发热，伴食欲减退、乏力、全身不适和头痛等一般“感冒”症状，或有腹痛、呕吐、腹泻、便秘等胃肠道症状以及咽痛、咳嗽、流涕等呼吸道症状。 | [
{
"id": 0,
"entity": "低热",
"start_offset": 20,
"end_offset": 22,
"label": "sym"
},
{
"id": 1,
"entity": "中度发热",
"start_offset": 23,
"end_offset": 27,
"label": "sym"
},
{
"id": 2,
"entity": "食欲减退",
"start_offset": 29,
"end_offset": 33,
"label": "sym"
},
{
"id": 3,
"entity": "乏力",
"start_offset": 34,
"end_offset": 36,
"label": "sym"
},
{
"id": 4,
"entity": "全身不适",
"start_offset": 37,
"end_offset": 41,
"label": "sym"
},
{
"id": 5,
"entity": "头痛",
"start_offset": 42,
"end_offset": 44,
"label": "sym"
},
{
"id": 6,
"entity": "感冒",
"start_offset": 48,
"end_offset": 50,
"label": "dis"
},
{
"id": 7,
"entity": "腹痛",
"start_offset": 56,
"end_offset": 58,
"label": "sym"
},
{
"id": 8,
"entity": "呕吐",
"start_offset": 59,
"end_offset": 61,
"label": "sym"
},
{
"id": 9,
"entity": "腹泻",
"start_offset": 62,
"end_offset": 64,
"label": "sym"
},
{
"id": 10,
"entity": "便秘",
"start_offset": 65,
"end_offset": 67,
"label": "sym"
},
{
"id": 11,
"entity": "胃肠道",
"start_offset": 68,
"end_offset": 71,
"label": "bod"
},
{
"id": 12,
"entity": "胃肠道症状",
"start_offset": 68,
"end_offset": 73,
"label": "sym"
},
{
"id": 13,
"entity": "咽痛",
"start_offset": 75,
"end_offset": 77,
"label": "sym"
},
{
"id": 14,
"entity": "咳嗽",
"start_offset": 78,
"end_offset": 80,
"label": "sym"
},
{
"id": 15,
"entity": "流涕",
"start_offset": 81,
"end_offset": 83,
"label": "sym"
},
{
"id": 16,
"entity": "呼吸道",
"start_offset": 84,
"end_offset": 87,
"label": "bod"
},
{
"id": 17,
"entity": "呼吸道症状",
"start_offset": 84,
"end_offset": 89,
"label": "sym"
}
] |
（二）瘫痪前期经2～6天的静止阶段，体温再次升高，进入瘫痪前期。 | [
{
"id": 0,
"entity": "瘫痪",
"start_offset": 3,
"end_offset": 5,
"label": "sym"
},
{
"id": 1,
"entity": "瘫痪",
"start_offset": 27,
"end_offset": 29,
"label": "sym"
}
] |
患者有全身兴奋状态，面赤、皮肤微红、多汗，可有呕吐和咽痛。 | [
{
"id": 0,
"entity": "全身兴奋状态",
"start_offset": 3,
"end_offset": 9,
"label": "sym"
},
{
"id": 1,
"entity": "面赤",
"start_offset": 10,
"end_offset": 12,
"label": "sym"
},
{
"id": 2,
"entity": "皮肤",
"start_offset": 13,
"end_offset": 15,
"label": "bod"
},
{
"id": 3,
"entity": "皮肤微红",
"start_offset": 13,
"end_offset": 17,
"label": "sym"
},
{
"id": 4,
"entity": "多汗",
"start_offset": 18,
"end_offset": 20,
"label": "sym"
},
{
"id": 5,
"entity": "呕吐",
"start_offset": 23,
"end_offset": 25,
"label": "sym"
},
{
"id": 6,
"entity": "咽痛",
"start_offset": 26,
"end_offset": 28,
"label": "sym"
}
] |
全身或四肢肌肉疼痛，感觉过敏，不愿他人抚抱。 | [
{
"id": 0,
"entity": "全身或四肢肌肉",
"start_offset": 0,
"end_offset": 7,
"label": "bod"
},
{
"id": 1,
"entity": "全身或四肢肌肉疼痛",
"start_offset": 0,
"end_offset": 9,
"label": "sym"
},
{
"id": 2,
"entity": "感觉过敏",
"start_offset": 10,
"end_offset": 14,
"label": "sym"
},
{
"id": 3,
"entity": "不愿他人抚抱",
"start_offset": 15,
"end_offset": 21,
"label": "sym"
}
] |
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