Gasnault J, Moore N, Arnaud F, Rondot P
Service de Neurologie, Centre Raymond Garcin, Hôpital Sainte-Anne, Paris, France.
Bull Eur Physiopathol Respir. 1987 Aug;23 Suppl 11:199s-202s.
Peripheral nervous system alterations during chronic obstructive airways disease (COAD) with respiratory insufficiency seem more frequent than usual neurological practice would suggest. Almost a third of COAD patients have clinical evidence of peripheral neuropathy and two thirds have electrophysiological abnormalities. The presentation consists of a polyneuropathy often subclinical or with predominantly sensory signs, which has the neurophysiological and pathological features of predominantly axonal neuropathy. The presumed etiopathogenic factors are multiple: chronic hypoxia, tobacco smoke (which contains at least three neurotoxic constituents) alcoholism, malnutrition and adverse effects of certain drugs. Hypoxia probably plays the leading part, either by direct action on nerves fibres or by enhancing the effects of other neurotoxic factors or deficiencies.
在伴有呼吸功能不全的慢性阻塞性气道疾病（COAD）期间，外周神经系统改变似乎比通常神经科临床所见更为常见。几乎三分之一的COAD患者有外周神经病变的临床证据，三分之二有 electrophysiological异常。其表现为一种多神经病变，常为亚临床型或主要有感觉体征，具有以轴索性神经病变为主的神经生理和病理特征。推测的病因因素有多种：慢性缺氧、烟草烟雾（至少含有三种神经毒性成分）、酗酒、营养不良以及某些药物的不良反应。缺氧可能起主要作用，要么通过直接作用于神经纤维，要么通过增强其他神经毒性因素或营养缺乏的影响。
