Ogura T, Makinodan A, Kubo T, Hayashida T, Hirasawa Y
Department of Orthopaedic Surgery, Kyoto Prefectural University of Medicine, Kamigyo, Kyoto 602-8566, Japan.
Postgrad Med J. 2001 Jul;77(909):451-4. doi: 10.1136/pmj.77.909.451.
The objective of this study was to confirm electrophysiologically both the presence and course of uraemic neuropathy in haemodialysis patients. Nerve conduction studies of the lower extremities were done in 70 haemodialysis patients and 20 normal volunteers. Compared with that in normal volunteers, the distal motor latency in the tibial nerve of patients was prolonged significantly (p<0.05), and the minimal F wave latency in the tibial nerve was also prolonged significantly (p<0.05). Motor conduction velocity in the tibial nerve was reduced significantly (p<0.05), and sensory nerve conduction velocity in the medial plantar nerve also was reduced significantly (p<0.05). These results suggest the presence of uraemic neuropathy in haemodialysis patients. Twenty patients were investigated by a follow up study five years later. Parameters from F wave conduction studies, which were thought to be the most useful in the evaluation of neuropathy, showed no significant differences between the initial and follow up trials. These observations suggest that uraemic neuropathy does not progress during haemodialysis. These results also suggest that most haemodialysis patients showed electrophysiological evidence of uraemic neuropathy, but no remarkable electrophysiological change in uraemic neuropathy during haemodialysis was recognised.
本研究的目的是通过电生理学方法证实血液透析患者中尿毒症神经病变的存在及其病程。对70例血液透析患者和20名正常志愿者进行了下肢神经传导研究。与正常志愿者相比,患者胫神经的远端运动潜伏期显著延长(p<0.05),胫神经的最小F波潜伏期也显著延长(p<0.05)。胫神经的运动传导速度显著降低(p<0.05),足底内侧神经的感觉神经传导速度也显著降低(p<0.05)。这些结果提示血液透析患者存在尿毒症神经病变。五年后对20例患者进行了随访研究。F波传导研究的参数被认为在神经病变评估中最有用,初始试验和随访试验之间没有显著差异。这些观察结果提示尿毒症神经病变在血液透析期间不会进展。这些结果还提示,大多数血液透析患者显示出尿毒症神经病变的电生理学证据,但在血液透析期间未发现尿毒症神经病变有明显的电生理学变化。