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类风湿关节炎足部畸形患者的感觉障碍和多发性神经病

Sensory disturbance and polyneuropathy in rheumatoid arthritis patients with foot deformity.

作者信息

Karaca Umay Ebru, Gurcay Eda, Karsli Pinar Bora, Cakci Aytul

机构信息

Physical Medicine and Rehabilitation Clinic, Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey.

Physical Medicine and Rehabilitation Clinic, Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey.

出版信息

Rev Bras Reumatol Engl Ed. 2016 May-Jun;56(3):191-7. doi: 10.1016/j.rbre.2015.08.010. Epub 2015 Sep 8.

Abstract

INTRODUCTION

Our aim in this study was to present the results of sensory evaluation tests and electrophysiological evaluations in rheumatoid arthritis (RA) patients with foot deformity and to determine their relation with general health status and lower extremity functionality.

MATERIALS AND METHODS

Fifty-one patients with RA diagnosis and foot deformity were included in the study. Demographic and disease characteristics of the patients were recorded, and a detailed neurological examination was performed. Superficial sensation, pain, heat, vibration, and two-point discrimination sensation were evaluated in each foot, and their sum was used to determine the sensory deficits index (SDI) of 0-10. The presence of polyneuropathy was evaluated with electrophysiological methods. The Health Assessment Questionnaire and mobility and walking subscales of the Arthritis Impact Measurement Scales-2 were used to assess general health status and lower extremity functionality, respectively. According to the sensory examination and electromyography results, patients were compared in terms of their general health status and lower extremity functional status.

RESULTS

Sensory disturbance was detected in 39 patients (74%) during the examination; however, 27 patients (52.9%) had polyneuropathy determined electrophysiologically. In patients with sensory deficits, statistically significant deterioration was detected in general health and foot functionality, including mobility and walking, when compared to patients with a normal sensory evaluation.

CONCLUSIONS

Even in the presence of normal electrophysiological tests, sensory dysfunction alone seems to be associated with severe disability in general health status and foot functionality when compared to patients with a normal sensory examination.

摘要

引言

本研究的目的是呈现类风湿关节炎(RA)足部畸形患者的感觉评估测试和电生理评估结果,并确定它们与总体健康状况和下肢功能的关系。

材料与方法

本研究纳入了51例确诊为RA且有足部畸形的患者。记录患者的人口统计学和疾病特征,并进行详细的神经学检查。对每只脚的浅感觉、疼痛、热、振动和两点辨别觉进行评估,其总和用于确定0至10的感觉缺陷指数(SDI)。采用电生理方法评估是否存在多发性神经病。分别使用健康评估问卷以及关节炎影响测量量表-2的活动和步行子量表来评估总体健康状况和下肢功能。根据感觉检查和肌电图结果,比较患者的总体健康状况和下肢功能状态。

结果

检查期间在39例患者(74%)中检测到感觉障碍;然而,通过电生理检查确定27例患者(52.9%)存在多发性神经病。与感觉评估正常的患者相比,感觉有缺陷的患者在总体健康和足部功能(包括活动和步行)方面出现了具有统计学意义的恶化。

结论

与感觉检查正常的患者相比,即使电生理测试正常,单独的感觉功能障碍似乎也与总体健康状况和足部功能的严重残疾有关。

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