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轴突反射性红斑和定量性汗出轴突反射有助于小纤维神经病的诊断。

Axon reflex flare and quantitative sudomotor axon reflex contribute in the diagnosis of small fiber neuropathy.

机构信息

Department of Physiology and Pathophysiology, University of Erlangen, Universitätsstr. 17, 91054, Erlangen, Germany.

出版信息

Muscle Nerve. 2013 Mar;47(3):357-63. doi: 10.1002/mus.23543. Epub 2012 Nov 24.

Abstract

INTRODUCTION

Objective diagnosis of small fiber impairment is difficult.

METHODS

We used the quantitative sudomotor axon reflex test (QSART) and axon-reflex-flare-test in the foot and thigh of 46 patients with peripheral neuropathy to assess C-fiber function in addition to conventional neurography and thermal threshold testing.

RESULTS

In all patients, small fiber impairment was suspected because of abnormal warmth detection thresholds (76% of all tested) and/or pain in the feet. A total of 83% had reduced axon-reflex flare areas and 17% lower QSART scores. Patients with pure small fiber neuropathy had higher rates of reduced flare areas (87.5%) and sweating rates (25.5%). There was no difference between patients with and without pain regarding thermotesting and axon-reflex testing.

CONCLUSIONS

Both axon-reflex tests are helpful to identify objectively patients with small fiber impairment. Afferent and efferent C-fiber classes can be impaired differently. These tests detect small fiber impairment, but they cannot differentiate between painful and nonpainful neuropathy.

摘要

简介

小纤维损害的客观诊断较为困难。

方法

我们对 46 例周围神经病变患者的足部和大腿进行了定量性自主神经反射试验(QSART)和轴突反射性红斑试验,除了常规神经电图和温度阈值测试外,还评估了 C 纤维功能。

结果

所有患者均因异常温热感觉阈值(所有测试的 76%)和/或足部疼痛而怀疑存在小纤维损害。轴突反射性红斑面积减少和 QSART 评分降低的患者分别占 83%和 17%。纯小纤维性神经病患者的红斑面积减少(87.5%)和出汗率(25.5%)更高。在热测试和轴突反射测试方面,有疼痛和无疼痛的患者之间没有差异。

结论

这两种轴突反射试验都有助于客观地识别小纤维损害的患者。传入和传出 C 纤维类可以不同程度地受损。这些测试可以检测小纤维损害,但不能区分疼痛性和非疼痛性神经病。

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