Situ Jie, Wu Jian, Wang Jing-lin, Zhu De-xiang, Zhang Jian-jie, Liu Wei-wei, Qin Zhuo-hui
Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2012 May;30(5):339-42.
To study the sympathetic skin response (SSR) to the effects of N-hexane on autonomic nerves function in patients with chronic N-hexane poisoning.
The subjects in present study included 30 controls and 37 cases with chronic N-hexane poisoning. Also 37 patients were divided into 3 subgroups (mild, moderate and severe poisoning) according to diagnostic criteria of occupational diseases. All subjects were examined by SSR test and nerve conduction velocity (NCV) test. All patients were reexamined by SSR and NCV every 1 ∼ 2 months. The differences in SSR parameters (latency, amplitude) among groups were observed. In the severe poisoning subgroup, the changes of SSR and NCV parameters (conduction velocity, amplitude) in different poisoning stages were observed.
There were significant differences in SSR latency of upper extremity among groups and the significant differences in SSR amplitude of upper and lower extremity among groups (P < 0.05). No significant differences in SSR parameters were found between the adjacent groups (P > 0.05). There were significant differences in SSR latency of upper extremity during different periods and the significant differences in SSR amplitude of upper and lower extremity during different periods among all groups (P < 0.05). The change of SSR parameters consistent with that in NCV. The longest SSR latency of upper extremity and the smallest SSR amplitudes of upper and lower extremity appears 1 - 2 months earlier than that of the smallest action potential amplitude.
The damage of autonomic nerves induced by N-hexane increased with poisoning progresses. The damage of autonomic nerves corresponded with the damage of myelin sheath of large myelinated nerves, but which appeared 1 - 2 months earlier than the damage of axon of large myelinated nerves. SSR test may serve as a method to detect the damage of autonomic nerves function in patients with chronic N-hexane poisoning.
研究慢性正己烷中毒患者交感神经皮肤反应(SSR)对自主神经功能的影响。
本研究对象包括30名对照者和37例慢性正己烷中毒患者。37例患者根据职业病诊断标准分为3个亚组(轻度、中度和重度中毒)。所有受试者均进行SSR试验和神经传导速度(NCV)试验。所有患者每1至2个月进行一次SSR和NCV复查。观察各组间SSR参数(潜伏期、波幅)的差异。在重度中毒亚组中,观察不同中毒阶段SSR和NCV参数(传导速度、波幅)的变化。
各组间上肢SSR潜伏期差异有统计学意义,上下肢SSR波幅差异有统计学意义(P<0.05)。相邻组间SSR参数差异无统计学意义(P>0.05)。各组不同时期上肢SSR潜伏期差异有统计学意义,不同时期上下肢SSR波幅差异有统计学意义(P<0.05)。SSR参数变化与NCV变化一致。上肢SSR最长潜伏期及上下肢SSR最小波幅出现时间比最小动作电位波幅早1至2个月。
正己烷所致自主神经损害随中毒进展而加重。自主神经损害与大髓鞘神经髓鞘损害相对应,但比大髓鞘神经轴索损害早1至2个月出现。SSR试验可作为检测慢性正己烷中毒患者自主神经功能损害的一种方法。