Vila A, Reymond F, Paramelle B, Stoebner P, Ouvrard-Hernandez A M, Muller P, Pollak P
Rev Electroencephalogr Neurophysiol Clin. 1986 Feb;15(4):331-40. doi: 10.1016/s0370-4475(86)80039-9.
In order to determine the frequency and the characteristics of neuropathies in chronic respiratory insufficiency, a systematic study of 43 patients affected by a chronic obstructive pulmonary disease was performed. In addition to neurological and electrophysiological examinations (including 6 nerve conduction studies on median, ulnar and peroneal nerves and EMG of 4 to 8 muscles), nerve and muscle biopsies (of the superficial peroneal nerve and lateral peroneus brevis muscle) were performed in 13 cases. Polyneuropathies were found in 74% patients: but mild in 39%, severe in 35%. Most were subclinical or poorly symptomatic. We determined the importance and distribution of abnormalities on the different nerves. From this we established that neuropathies are mixed but predominantly of the axonal type. Axonal degeneration and demyelination were confirmed by nerve biopsy; muscles presented neurogenic atrophy. Statistical analysis showed that the duration of hypoxemia was related to neuropathy. The pathogeny of these neuropathies is discussed.
为了确定慢性呼吸功能不全患者神经病变的发生率及特征,我们对43例慢性阻塞性肺疾病患者进行了系统研究。除了进行神经学和电生理学检查(包括对正中神经、尺神经和腓总神经进行6次神经传导研究以及对4至8块肌肉进行肌电图检查)外,还对13例患者进行了神经和肌肉活检(腓浅神经和腓骨短肌外侧)。74%的患者发现有多发性神经病变:其中39%为轻度,35%为重度。大多数为亚临床型或症状轻微。我们确定了不同神经上异常的重要性和分布情况。由此我们确定神经病变为混合型,但以轴索性为主。神经活检证实有轴索变性和脱髓鞘;肌肉呈现神经源性萎缩。统计分析表明低氧血症的持续时间与神经病变有关。本文还讨论了这些神经病变的发病机制。