皮肌炎或多发性肌炎患者的神经传导研究。

Nerve conduction studies in patients with dermatomyositis or polymyositis.

机构信息

Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.

出版信息

Chin Med J (Engl). 2010 Mar 5;123(5):523-6.

PMID:20367974

Abstract

BACKGROUND

Involvement of peripheral nerves in dermatomyositis (DM) and polymyositis (PM) is less well known. In the present study we retrospectively analyzed the clinical and electrophysiological records of hospital inpatients with a diagnosis of DM or PM to investigate the association of DM/PM and peripheral neuropathy.

METHODS

The data of inpatients diagnosed with DM or PM were collected in Peking Union Medical College Hospital, and 186 patients (118 patients with DM and 68 with PM) were retrospectively analyzed. Nerve conduction studies (NCSs) of the median nerve, ulnar nerve, posterior tibial nerve, and common peroneal nerve were examined simultaneously.

RESULTS

There were 71 (38.2%) patients with abnormal NCS findings, 37 (19.9%) with pure motor involvement (decreased compound muscle action potential, CMAP), and 34 (18.3%) with peripheral neuropathy. Of the 34 peripheral neuropathy patients, 14 (7.5%) had polyneuropathy, 1 (0.5%) had multiple mononeuropathy, 16 (8.6%) had carpal tunnel syndrome (CTS), 1 (0.5%) had trigeminal sensory neuropathy, 1 (0.5%) had ulnar sensory neuropathy, and 1 (0.5%) had brachial plexus involvement. The prevalence of malignant disease (3/34, 8.8%), other connective tissue diseases (CTDs) (7/34, 20.6%) and diabetes (6/34, 17.6%) was significantly greater in DM/PM patients with peripheral neuropathy (chi(2) = 15.855, P = 0.000) compared with DM/PM patients without involvement of peripheral nerves (5/115, 4.3% and 7/115, 6.1%, respectively).

CONCLUSIONS

Peripheral neuropathy in DM/PM often suggests a complication with cancer, other CTDs, diabetes or CTS. From a practical point of view, NCS for DM/PM may help find the underlying disorders.

摘要

背景

皮肌炎（DM）和多发性肌炎（PM）累及周围神经的情况不太为人所知。在本研究中，我们回顾性分析了我院诊断为 DM 或 PM 的住院患者的临床和电生理记录，以研究 DM/PM 与周围神经病的关系。

方法

收集北京协和医院住院患者的 DM 或 PM 诊断数据，回顾性分析 186 例患者（118 例 DM，68 例 PM）。同时检查正中神经、尺神经、胫后神经和腓总神经的神经传导研究（NCS）。

结果

71 例（38.2%）患者 NCS 异常，37 例（19.9%）为单纯运动受累（复合肌肉动作电位 CMAP 降低），34 例（18.3%）为周围神经病。34 例周围神经病患者中，14 例（7.5%）为多发性神经病，1 例（0.5%）为多神经病，16 例（8.6%）为腕管综合征（CTS），1 例（0.5%）为三叉神经感觉神经病，1 例（0.5%）为尺神经感觉神经病，1 例（0.5%）为臂丛神经病。伴周围神经病的 DM/PM 患者恶性肿瘤（3/34，8.8%）、其他结缔组织病（CTD）（7/34，20.6%）和糖尿病（6/34，17.6%）的患病率明显高于无周围神经受累的 DM/PM 患者（卡方检验，x(2) = 15.855，P = 0.000）（5/115，4.3%和 7/115，6.1%）。