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[巴西塞阿拉州福塔莱萨市麻风病患者的无症状神经病变]

[Silent neuropathy in patients with leprosy in the city of Fortaleza, Ceará State, Brazil].

作者信息

Leite Vyna Maria Cruz, Lima José Wellington de Oliveira, Gonçalves Heitor de Sá

机构信息

Universidade Estadual do Ceará, Rua Alberto Torres 151, Fortaleza, CE, Brazil.

出版信息

Cad Saude Publica. 2011 Apr;27(4):659-65. doi: 10.1590/s0102-311x2011000400005.

Abstract

One of the clinical forms of Hansen's disease is silent neuropathy, which consists of progressive nerve damage in the absence of pain and hypersensitivity to palpation. This study estimated the proportion of silent neuropathy and associated factors. A cross-sectional study was performed in Fortaleza, Ceará State, Brazil. Patients were asked about the presence of decreased sensation involving touch, heat, pain, and numbness. Nerves were palpated to identify thickness, abscess, and pain. Lymph samples were drawn for parasitological tests. Strength of voluntary muscles in the feet and hands was evaluated. The sensitivity of specific points on the feet and hands was measured using Semmes-Weinstein monofilament. The sample included 233 patients. The proportion of silent neuropathy was 5.6% (95%CI: 3.0-9.4), and factors significantly associated with silent neuropathy were: age (p = 0.011) and disability (p < 0.000). These results will help identify cases of silent neuropathy, targeting patients at higher risk.

摘要

麻风病的临床形式之一是无症状性神经病变,其表现为在无疼痛及触诊过敏的情况下出现进行性神经损伤。本研究估算了无症状性神经病变的比例及相关因素。在巴西塞阿拉州福塔莱萨进行了一项横断面研究。询问患者是否存在涉及触觉、热觉、痛觉及麻木感的感觉减退情况。触诊神经以确定其粗细、有无脓肿及疼痛。采集淋巴样本进行寄生虫学检测。评估足部和手部随意肌的力量。使用Semmes-Weinstein单丝测量足部和手部特定部位的敏感性。样本包括233名患者。无症状性神经病变的比例为5.6%(95%置信区间:3.0 - 9.4),与无症状性神经病变显著相关的因素为:年龄(p = 0.011)和残疾情况(p < 0.000)。这些结果将有助于识别无症状性神经病变病例,针对高危患者进行治疗。

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