Teschan P E, Ginn H E, Bourne J R, Ward J W, Hamel B, Nunnally J C, Musso M, Vaughn W K
Kidney Int. 1979 Jun;15(6):676-97. doi: 10.1038/ki.1979.88.
The disabling, dialysis-responsive symptoms of clinical uremia primarily represent impaired functions of the nervous system. Accordingly, these studies used several quantitative electrophysiologic and cognition-dependent probes of nervous system function: peripheral nerve-conduction velocity, response latency and amplitude; electroencephalographic (EEG) power-spectrum analysis; visual evoked response latency; EEG responses to photic driving; and measures of integrated behavioral performance that stressed sustained and selective attention, reaction time, speed of decision-making, short-term memory, and mental manipulation of symbols. Probes of quanitified central nervous system function consistently revealed impairments that varied directly with the degree of renal failure, that improved following onset of maintenance dialysis, and that improved still further after successful renal transplantation. In contrast, measures of peripheral nerve function were generally unchanged. Neurobehavioral measures that are relevant to uremic symptomatology provide quantitative estimates of the clinically significant, whole-organism biologic effects of renal failure and its several treatments. Applications of such measures in studies of symptomatic states other than uremia are indicated also.
临床尿毒症导致功能障碍且对透析有反应的症状主要表现为神经系统功能受损。因此，这些研究使用了多种定量电生理和依赖认知的神经系统功能检测方法：外周神经传导速度、反应潜伏期和波幅；脑电图（EEG）功率谱分析；视觉诱发电位潜伏期；EEG对光驱动的反应；以及强调持续和选择性注意力、反应时间、决策速度、短期记忆和符号心理操作的综合行为表现测量方法。量化中枢神经系统功能的检测方法一致显示出与肾衰竭程度直接相关的损伤，这些损伤在维持性透析开始后有所改善，在成功进行肾移植后进一步改善。相比之下，外周神经功能的检测结果通常没有变化。与尿毒症症状学相关的神经行为测量方法提供了肾衰竭及其几种治疗方法对临床上具有重要意义的全生物体生物学效应的定量评估。这些测量方法在尿毒症以外的症状状态研究中的应用也有提及。
