16例重度正己烷中毒性神经病患者的电生理研究
[Electrophysiological study of 16 patients with severe N-hexane neuropathy].
作者信息
Jiang Hong, Chen Lei-qian, Hu Yue-yu
机构信息
Department of Neurology, Sir Run Run Shaw Hospital, Medical School of Zhejiang University, Hangzhou 310016, China.
出版信息
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2005 Oct;23(5):351-4.
OBJECTIVE
To observe electrophysiological changes of severe N-hexane neuropathy getting active therapies and discuss its prognosis.
METHODS
A follow-up study involved 16 adult severe N-hexane neuropathy patients who got active therapies was performed. EMG in right muscle of thenar, tibial muscle, and vastus medialis, NCV in right median nerve, common peroneal nerve, and sural nerve were determined and analyzed before treatment and in the first, the third, the ninth, and the twenty-fourth month after treatment.
RESULTS
The electrophysiology in severe N-hexane neuropathy patients showed that the voluntary potential during muscle relaxation increased by 25.0%; the motor unit potential time limit prolonged by 20.8%, and the amplitude increased by 12.5%, and multiphasic wave increased by 16.5% during mild contraction; the raise decreased by 25.0% during strong contraction. In control group, the MCV, SCV, SNAP, DML, and CMAP of median nerve were (54.63 +/- 5.33) m/s, (59.25 +/- 6.45) m/s, (26.53 +/- 6.32) microV, (3.96 +/- 0.65)ms, and (9.89 +/- 2.30) mV respectively, the MCV, CMAP, DML of common peroneal nerve were (48.49 +/- 3.25) m/s, (5.47 +/- 1.77) mV, (5.20 +/- 1.27) ms respectively, and the SCV, SNAP of sural nerve were (63.21 +/- 9.30) m/s, (4.63 +/- 1.29) microV respectively. Severe N-hexane neuropathy patients presented significantly different abnormalities in the NCV and EMG (P < 0.01). The MCV, SCV, SNAP, DML, CMAP of median nerve were (46.00 +/- 4.32) m/s, (40.66 +/- 2.65) m/s, (7.98 +/- 1.05) microV, (4.28 +/- 0.63) ms, and (6.32 +/- 1.54) mV respectively. The MCV, CMAP, DML of common peroneal nerve were (48.49 +/- 3.25) m/s, (3.21 +/- 1.99) mV, (7.32 +/- 1.65) ms respectively. The SCV, SNAP of sural nerve were (36.48 +/- 5.20) m/s, (2.15 +/- 1.22) microV respectively. These parameters gradually recovered to normal levels in 24 months after treatment.
CONCLUSION
The electrophysiological abnormalities in severe N-hexane neuropathy patients can restore after treatment, and clinical prognosis is good.
目的
观察重症正己烷中毒性神经病患者接受积极治疗后的电生理变化，并探讨其预后。
方法
对16例接受积极治疗的成年重症正己烷中毒性神经病患者进行随访研究。分别于治疗前、治疗后第1个月、第3个月、第9个月及第24个月测定并分析右侧大鱼际肌、胫前肌及股内侧肌的肌电图（EMG），右侧正中神经、腓总神经及腓肠神经的神经传导速度（NCV）。
结果
重症正己烷中毒性神经病患者的电生理表现为：肌肉放松时自发电位增多25.0%；轻度收缩时运动单位电位时限增宽20.8%，波幅增高12.5%，多相波增多16.5%；大力收缩时波幅增高值下降25.0%。对照组正中神经运动传导速度（MCV）、感觉传导速度（SCV）、感觉神经动作电位（SNAP）、远端运动潜伏期（DML）及复合肌肉动作电位（CMAP）分别为（54.63±5.33）m/s、（59.25±6.45）m/s、（26.53±6.32）μV、（3.96±0.65）ms及（9.89±2.30）mV；腓总神经MCV、CMAP、DML分别为（48.49±3.25）m/s、（5.47±1.77）mV、（5.20±1.27）ms；腓肠神经SCV、SNAP分别为（63.21±9.30）m/s、（4.63±1.29）μV。重症正己烷中毒性神经病患者的NCV及EMG异常与对照组比较差异有统计学意义（P<0.01）。正中神经MCV、SCV、SNAP、DML、CMAP分别为（46.00±4.32）m/s、（40.66±2.65）m/s、（7.98±1.05）μV、（4.28±0.63）ms及（6.32±1.54）mV；腓总神经MCV、CMAP、DML分别为（48.49±3.25）m/s、（3.21±1.99）mV、（7.32±1.65）ms；腓肠神经SCV、SNAP分别为（36.48±5.20）m/s、（2.15±1.22）μV。治疗后24个月这些指标逐渐恢复至正常水平。
结论
重症正己烷中毒性神经病患者的电生理异常在治疗后可恢复，临床预后良好。
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