Pamukkale University, Denizli, Turkey.
COPD. 2010 Feb;7(1):11-6. doi: 10.3109/15412550903499480.
The aim of this study was to evaluate the frequency and characteristics of peripheral nervous system involvement in chronic obstructive pulmonary disease and its relation with proinflammatory cytokines such as TNF-alpha, IL-6, IGF-1 and CRP. Forty chronic obstructive pulmonary disease patients with a mean age 62.8 +/- 5.5 years and 33 healthy controls with a mean age of 61.8 +/- 7.4 were included into this study. All subjects were evaluated with standard motor and sensory nerve conduction studies. Serum TNF-alpha, IL-6, CRP and IGF-1 were measured. The muscle strengths of three muscle groups (knee extensors, shoulder abductors and flexors) were assessed with a hand-held dynamometer. Peripheral neuropathy was detected at 15% of chronic obstructive pulmonary disease patients. Ulnar motor and sensory nerves, left sural nerve distal latencies were found significantly prolonged than healthy volunteers (p = 0.011), peroneal nerve conduction velocities was found lower in patients than in healthy controls (p = 0.021), tibial nerve amplitudes was found lower in patients than healthy controls (p = 0.046). CRP and TNF-alpha were found significantly higher in chronic obstructive pulmonary disease patients and IGF-1 was found significantly lower in chronic obstructive pulmonary disease patients. There was no correlations between proinflammatory cytokines, CRP and electrophysiological findings. Left sural nerve's sensory nerve action potential amplitude was correlated positively with FEV(1)% (r = 0.425; p = 0.009). Muscle strength at the shoulder and knee were significantly reduced in patients with COPD when compared with controls. The frequency of neuropathy was higher in chronic obstructive pulmonary disease when compared with the healthy controls. Chronic obstructive pulmonary disease patients have subclinical peripheral nerve involvements.
本研究旨在评估慢性阻塞性肺疾病（COPD）患者外周神经系统受累的频率和特征，及其与促炎细胞因子（如 TNF-α、IL-6、IGF-1 和 CRP）的关系。本研究纳入了 40 名平均年龄为 62.8 ± 5.5 岁的 COPD 患者和 33 名平均年龄为 61.8 ± 7.4 岁的健康对照者。所有受试者均接受了标准的运动和感觉神经传导研究。测量了血清 TNF-α、IL-6、CRP 和 IGF-1。使用手持测力计评估了三组肌肉（膝关节伸肌、肩部外展肌和屈肌）的肌肉力量。在 15%的 COPD 患者中检测到周围神经病变。与健康志愿者相比，尺神经运动和感觉神经、左侧腓肠神经远端潜伏期明显延长（p = 0.011），患者的腓总神经传导速度较健康对照组低（p = 0.021），患者的胫神经振幅较健康对照组低（p = 0.046）。与健康对照组相比，COPD 患者的 CRP 和 TNF-α明显升高，IGF-1明显降低。促炎细胞因子、CRP 与电生理检查结果之间无相关性。左侧腓肠神经感觉神经动作电位幅度与 FEV（1）%呈正相关（r = 0.425；p = 0.009）。与对照组相比，COPD 患者的肩部和膝关节肌肉力量明显减弱。与健康对照组相比，COPD 患者的周围神经病发生率更高。COPD 患者存在亚临床外周神经受累。
