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[持续性非卧床腹膜透析患者中多神经病体征的发生率]

[Frequency of polyneuropathy signs in CAPD patients].

作者信息

Jovanović Dijana, Matanović Dragana, Stosović Milan, Bontić Ana, Nesić Vidosava

机构信息

Institut za urologiju i nefrologiju, Klinicki centar Srbije, Beograd.

出版信息

Med Pregl. 2007;60 Suppl 2:142-4.

Abstract

INTRODUCTION

It is well known that polyneuropathy has been an important cause of disability in patients maintained on hemodialysis as well as on peritoneal dialysis. The present study was aimed to analyze frequency and causes of polyneuropathy in patients on continuous ambulatory peritoneal dialysis (CAPD).

MATERIAL AND METHODS

Sixty three CAPD patients (37 men), aged between 30 and 85 who were on dialysis from 1 to 290 months, were analyzed. Biochemical parameters and dialysis adequacy (KT/V) were determined. Motor conduction velocity (MCV) of peroneal and tibial nerve, and sensitive conduction velocity (SCV) on sural nerve were measured.

RESULTS AND DISCUSSION

Biochemical parameters and dialysis adequacy were satisfactory in patients on CAPD. Polyneuropathy symptoms like paresthesias, pain, cramps and disability were found in more than 50% of patients. Over 80% of analyzed patients had pathological neurophysiological parameters: latency of F wave of n. peroneus and all analyzed parameters of n. tibialis, as the well as SCV on the sural nerve. A significant correlation was found between peroneal MCV and age, glycemia and serum creatinine; peroneal terminal latency (TL) and age; peroneal F wave and glycemia and serum urea; tibial MCV and glycemia; tibial F wave and glycemia, serum urea and KT/V.

CONCLUSION

The most frequent signs of uremic polyneuropathy are reduced SCV on sural nerve and prolonged latency of F wave on peroneal and tibial nerves. Neurophysiological parameters on the lower extremities in patients on CAPD are in correlation with dialysis adequacy, glycemia and age.

摘要

引言

众所周知,多发性神经病一直是维持性血液透析和腹膜透析患者致残的重要原因。本研究旨在分析持续性非卧床腹膜透析(CAPD)患者多发性神经病的发生率及病因。

材料与方法

分析63例CAPD患者(37例男性),年龄在30至85岁之间,透析时间为1至290个月。测定生化参数及透析充分性(KT/V)。测量腓总神经和胫神经的运动传导速度(MCV)以及腓肠神经的感觉传导速度(SCV)。

结果与讨论

CAPD患者的生化参数及透析充分性良好。超过50%的患者出现了感觉异常、疼痛、痉挛和残疾等多发性神经病症状。超过80%的分析患者存在神经生理参数异常:腓总神经F波潜伏期以及胫神经的所有分析参数,还有腓肠神经的SCV。发现腓总神经MCV与年龄、血糖和血清肌酐之间存在显著相关性;腓总神经终末潜伏期(TL)与年龄之间存在显著相关性;腓总神经F波与血糖和血清尿素之间存在显著相关性;胫神经MCV与血糖之间存在显著相关性;胫神经F波与血糖、血清尿素和KT/V之间存在显著相关性。

结论

尿毒症性多发性神经病最常见的体征是腓肠神经SCV降低以及腓总神经和胫神经F波潜伏期延长。CAPD患者下肢的神经生理参数与透析充分性、血糖和年龄相关。

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