Abstract: Objective:To discuss the clinical manifestations and early combined diagnosis of subacute combined degeneration(SCD)of the spinal cord. Methods:The clinical data of 18 patients with SCD were collected,and the clinical manifestations and the levels of serum vitamin B12(VB12)and homocysteine(Hcy),mean corpuscular hemoglobin(MCH) levels,and mean corpuscular volume (MCV) were detected.The abnormal appearence of electrophysiological examination of the SCD patients was analyzed. Results:There were 12 cases of limb numbness in 18 SCD patients,10 cases of motor disturbance,1 case of blurred vision,4 cases of mental abnormality,and 2 cases of urinary disturbance.Among the 18 patients,the serum VB12 levels were decreased in 9 cases (50.0%),the Hcy levels were increased in 18 cases (100%),the MCV were increased in 15 cases(83.3%) and the MCH levels were increased in 14 cases (77.8%).The results of neuroelectrophysiological examination in 15 patients were all positive. Conclusion:The patients with SCD lack of the characteristic clinical manifestations.The diagnosis rate of SCD is low by the lack of serum VB12,and the combined detection of serum VB12,Hcy,MCV,MCH and electrophysiological examination is of great significance for the early diagnosis of SCD.

Key words: homocysteine, subacute combined degeneration of spinal cord, mean corpuscular volume, vitamin B12, neuroelectrophysiology