Sun Bo, Li Yifan, Liu Lizhi, Chen Zhaohui, Ling Li, Yang Fei, Liu Jiexiao, Liu Hong, Huang Xusheng
a Department of Neurology , Chinese PLA General Hospital , Beijing , China.
Int J Neurosci. 2018 May;128(5):442-448. doi: 10.1080/00207454.2017.1398152. Epub 2017 Nov 21.
Purpose/aim of the study: To date, there are no validated screening scales for small fibre neuropathy. This study investigated the small-fibre neuropathy and the symptom inventory questionnaire as well as the small fibre neuropathy screening list for small fibre neuropathy diagnosis.
Fifty-five patients were divided into small fibre neuropathy and mixed fibre damage groups. Relevant scales, nerve conduction studies and skin biopsies were performed. Relationships between the intraepidermal nerve fibre density and different scales as well as the diagnostic and cut-off values (score at which Youden's index is largest) were determined.
Compared with healthy Chinese participants, 20 patients were diagnosed with small fibre neuropathy. Intraepidermal nerve fibre density was moderately and highly correlated with the small fibre neuropathy-symptom inventory questionnaire and small fibre neuropathy screening list, respectively. The diagnostic values were moderate and high for the small fibre neuropathy-symptom inventory questionnaire (cut-off value = 5, sensitivity = 80%, specificity = 81.8%) and small fibre neuropathy screening list (cut-off value = 8, sensitivity = 94.1%, specificity = 90.9%), respectively. There were no significant differences in the visual analogue scale between the small fibre neuropathy group, mixed small and large fibre neuropathy group, pure large fibre neuropathy group and the normal group.
Small fibre neuropathy-symptom inventory questionnaire and small fibre neuropathy screening list represent potential small fibre neuropathy screening tools. Abbreviations EMG electromyography ENA anti-extractable nuclear antigens ESR erythrocyte sedimentation rate IENFD intraepidermal nerve fibre density IGT impaired glucose tolerance NCS nerve conduction studies NDS neuropathy disability score OGTT oral glucose tolerance test PGP protein gene product PN peripheral neuropathy ROC receiver operating characteristic curve ROC-AUC area under the ROC curve SFN small fibre neuropathy SFN-SIQ small-fibre neuropathy and symptom inventory questionnaire SFNSL small fibre neuropathy screening list VAS visual analogue scale WHO World Health Organization.
研究目的：迄今为止，尚无用于小纤维神经病变的经过验证的筛查量表。本研究调查了小纤维神经病变及症状清单问卷以及用于小纤维神经病变诊断的小纤维神经病变筛查清单。
55例患者被分为小纤维神经病变组和混合纤维损伤组。进行了相关量表评估、神经传导研究和皮肤活检。确定了表皮内神经纤维密度与不同量表之间的关系以及诊断和临界值（约登指数最大时的分数）。
与健康中国参与者相比，20例患者被诊断为小纤维神经病变。表皮内神经纤维密度分别与小纤维神经病变症状清单问卷和小纤维神经病变筛查清单呈中度和高度相关。小纤维神经病变症状清单问卷（临界值=5，敏感性=80%，特异性=81.8%）和小纤维神经病变筛查清单（临界值=8，敏感性=94.1%，特异性=90.9%）的诊断价值分别为中等和较高。小纤维神经病变组、小和大混合纤维神经病变组、单纯大纤维神经病变组和正常组之间的视觉模拟量表无显著差异。
小纤维神经病变症状清单问卷和小纤维神经病变筛查清单是潜在的小纤维神经病变筛查工具。缩写：EMG肌电图；ENA抗可提取核抗原；ESR红细胞沉降率；IENFD表皮内神经纤维密度；IGT糖耐量受损；NCS神经传导研究；NDS神经病变残疾评分；OGTT口服葡萄糖耐量试验；PGP蛋白基因产物；PN周围神经病变；ROC受试者工作特征曲线；ROC-AUC ROC曲线下面积；SFN小纤维神经病变；SFN-SIQ小纤维神经病变及症状清单问卷；SFNSL小纤维神经病变筛查清单；VAS视觉模拟量表；WHO世界卫生组织
