Wang Hongli, Fan Dongsheng, Wang Xin
Department of Neurology, Peking University Third Hospital, Beijing 100191, China.
Department of Neurology, Peking University Third Hospital, Beijing 100191, China. Email:
Zhonghua Nei Ke Za Zhi. 2014 Oct;53(10):778-82.
To explore the diagnostic value of corneal confocal microscopy in the early small fibre neuropathy (SFN).
A total of 45 patients with small fibre neuropathy and 50 age-matched healthy subjects undertook a neurological evaluation, neurological deficits score (NDS), sural nerve conduction velocity, contact heat evoked potential (CHEP) and corneal confocal microscopy (CCM) to quantify small nerve fibre pathology. Four parameters including nerve fiber length (NFL), nerve branch density (NBD), nerve fiber density (NFD) and nerve fibre tortuosity (NFT) were calculated from the observation of corneal confocal microscopy.
Compared with the control group, significantly decreased NFD and NBD were found in the SFN group [ (42.00 ± 25.26)/mm(2) vs (72.38 ± 14.09)/mm(2) ;(31.93 ± 13.21)/mm(2) vs (46.24 ± 11.48)/mm(2); with all P < 0.05], while NFT were significantly increased in the SFN group [(2.48 ± 0.87) levels vs (0.88 ± 0.56) levels, P < 0.001]. The neurological deficits score was correlated with NFT, NFD and NBD (r = 0.782, -0.376, -0.504; with all P < 0.001).
CCM is a new and sensitive noninvasive clinical technique that may be used to detect early small fibre nerve damage in patients with SFN.
探讨角膜共焦显微镜在早期小纤维神经病变（SFN）中的诊断价值。
共有45例小纤维神经病变患者和50例年龄匹配的健康受试者接受了神经学评估、神经功能缺损评分（NDS）、腓肠神经传导速度、接触热诱发电位（CHEP）以及角膜共焦显微镜检查（CCM），以量化小神经纤维病变情况。通过角膜共焦显微镜观察计算出神经纤维长度（NFL）、神经分支密度（NBD）、神经纤维密度（NFD）和神经纤维迂曲度（NFT）四个参数。
与对照组相比，SFN组的NFD和NBD显著降低[（42.00±25.26）/mm² 对比 （72.38±14.09）/mm²；（31.93±13.21）/mm² 对比 （46.24±11.48）/mm²；所有P<0.05]，而SFN组的NFT显著增加[（2.48±0.87）级对比 （0.88±0.56）级，P<0.001]。神经功能缺损评分与NFT、NFD和NBD相关（r = 0.782，-0.376，-0.504；所有P<0.001）。
CCM是一种新型且敏感的非侵入性临床技术，可用于检测SFN患者早期的小纤维神经损伤。
