用于诊断小纤维神经病变的皮肤皱纹：与表皮神经密度及交感神经皮肤反应的比较
Skin wrinkling for diagnosing small fibre neuropathy: comparison with epidermal nerve density and sympathetic skin response.
作者信息
Teoh H L, Chow A, Wilder-Smith E P
机构信息
Neurology, National University Hospital, Singapore.
出版信息
J Neurol Neurosurg Psychiatry. 2008 Jul;79(7):835-7. doi: 10.1136/jnnp.2007.140947. Epub 2008 Feb 12.
OBJECTIVE
To compare simple tests of small nerve fibre function with intraepidermal nerve fibre density (IENFD) in the evaluation of small fibre neuropathy (SFN).
METHODS
Patients with idiopathic SFN of the hands were prospectively studied. Evaluation involved clinical examination, nerve conduction studies, sympathetic skin response (SSR) and skin wrinkling stimulated by water and EMLA (eutectic mixture of local anaesthetics).
RESULTS
Of 21 patients, 16 (76%) had low IENFD, 15 (71%) impaired water-induced wrinkling, 14 (67%) impaired EMLA-induced wrinkling, and nine (43%) abnormal SSR.
CONCLUSIONS
Stimulated skin wrinkling was nearly as sensitive as IENFD in diagnosing SFN, whereas SSR was of less use. Stimulated skin wrinkling is a useful supportive test when IENFD or other tests of small nerve fibre function are not available.
目的
在评估小纤维神经病变（SFN）时，比较小神经纤维功能的简单测试与表皮内神经纤维密度（IENFD）。
方法
对特发性手部SFN患者进行前瞻性研究。评估包括临床检查、神经传导研究、交感神经皮肤反应（SSR）以及水和EMLA（局部麻醉剂的共熔混合物）刺激引起的皮肤起皱。
结果
21例患者中，16例（76%）IENFD较低，15例（71%）水诱导起皱受损，14例（67%）EMLA诱导起皱受损，9例（43%）SSR异常。
结论
在诊断SFN时，刺激引起的皮肤起皱与IENFD的敏感性相近，而SSR的作用较小。当无法进行IENFD或其他小神经纤维功能测试时，刺激引起的皮肤起皱是一项有用的辅助测试。
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