Brain Behav. 2012 May;2(3):249-55. doi: 10.1002/brb3.40.
A need still exists to determine the clinical and neurophysiological characteristics of leprosy neuropathy at distinct times of the disease by different methods that measure the various nerve fiber functions. A prospective clinical study was performed with 10 paucibacillary (PB) and 12 multibacillary (MB) patients evaluated at diagnosis and one year after cessation of multidrug therapy (MDT). Peripheral nerve function was assessed clinically and by means of the sympathetic skin response, skin vasomotor reflex, and nerve conduction study (NCS). At diagnosis, 73% of the total 22 patients had nerve function impairment (NFI). Autonomic function (χ(2)= 5.5, P= 0.019) and NCS (χ(2)= 7.765, P= 0.01) were significantly more altered in MB than PB patients. At final evaluation, NFI of the MB patients had worsened, especially among the six who had leprosy reaction. As the NFI of PB patients showed improvement, a significant difference between the two groups (χ(2)= 12.320, P= 0.001) was observed. A high prevalence of neuropathy was observed in newly diagnosed patients. Associating different tests with a thorough clinical neurological evaluation increases detection rates.
仍需要通过不同的方法，即在疾病的不同时间，使用测量各种神经纤维功能的方法，来确定麻风性神经病的临床和神经生理学特征。对 10 例少菌型（PB）和 12 例多菌型（MB）患者进行了前瞻性临床研究，这些患者在诊断时和停止多药治疗（MDT）一年后进行了评估。通过交感皮肤反应、皮肤血管运动反射和神经传导研究（NCS）进行临床和周围神经功能评估。在诊断时，22 例患者中有 73%存在神经功能障碍（NFI）。自主神经功能（χ²=5.5，P=0.019）和 NCS（χ²=7.765，P=0.01）在 MB 患者中明显比 PB 患者更异常。在最终评估时，MB 患者的 NFI 恶化，特别是在发生麻风反应的六名患者中。随着 PB 患者的 NFI 改善，两组之间存在显著差异（χ²=12.320，P=0.001）。新诊断的患者中观察到较高的神经病变患病率。将不同的测试与彻底的临床神经学评估相结合，可以提高检测率。
