Ohta Y, Fujimoto O, Nan'no H, Asao H, Fujii H
Sangyo Igaku. 1985 Sep;27(5):318-27. doi: 10.1539/joh1959.27.318.
Somatosensory evoked responses (SERs) to mechanical stimulation were recorded in 5 patients with occupational vibration disease and 10 grader drivers, and the results were compared with those obtained from 48 normal subjects. SERs were recorded at room temperature of 20-23 degrees C and after immersing the hand in hot (40 degrees C) or cold (10 degrees C) water for 5 minutes. SERs were also recorded while depressing the brachium and soon thereafter to examine the effect of ischemia. The following results were obtained. In SERs recorded on the finger of patients with occupational vibration disease, it was observed that some peaks of SERs were absent in 6 out of the 10 cases and that peak latency time was abnormally prolonged in 3 out of them. On the other hand, in SERs recorded on the forearm, abnormality was observed in only 1 out of them. In recording SERs in 6 patients with occupational vibration disease after immersing the hands in hot water, it was observed that abnormal SERs became normal in all 6 cases. However, these normalized SERs became abnormal in 5 out of the 6 cases within 25 minutes after removing the hands from hot water. No appreciable change could be observed in SERs recorded after immersing the hands in cold water. Partial absence of SER peaks could be observed in 2 out of 9 grader drivers while depressing the brachium. On the other hand, all SERs in 7 normal cases did not show any abnormality while depressing the brachium. The results suggest the presence of a close relationship between peripheral vascular dysfunction and peripheral somatosensory disturbance in patients with occupational vibration disease. However, it was observed that peripheral vascular dysfunction could not always trigger peripheral neural dysfunction. These findings have led to the conclusion that SERs to mechanical stimulation are more useful in the diagnosis of dysfunction of the peripheral nerve in patients with occupational vibration disease than SERs to electrical stimulation. The findings suggest that immersion in hot water and cold water and depression of the brachium are useful sensory tests for patients with occupational vibration disease and grader drivers.
对5例职业性振动病患者和10名平地机驾驶员进行了对机械刺激的体感诱发电位（SERs）记录，并将结果与48名正常受试者的结果进行比较。在20 - 23摄氏度的室温下以及将手浸入热水（40摄氏度）或冷水（10摄氏度）5分钟后记录SERs。在压迫上臂时及之后不久也记录SERs，以检查缺血的影响。获得了以下结果。在职业性振动病患者手指记录的SERs中，观察到10例中有6例SERs的一些波峰缺失，其中3例波峰潜伏期时间异常延长。另一方面，在前臂记录的SERs中，仅1例出现异常。在6例职业性振动病患者将手浸入热水后记录SERs时，观察到所有6例异常的SERs均恢复正常。然而，在将手从热水中取出后25分钟内，这6例恢复正常的SERs中有5例再次变为异常。将手浸入冷水后记录的SERs未观察到明显变化。在9名平地机驾驶员压迫上臂时，有2例观察到SERs波峰部分缺失。另一方面，7例正常受试者在压迫上臂时所有SERs均未显示任何异常。结果表明职业性振动病患者外周血管功能障碍与外周体感障碍之间存在密切关系。然而，观察到外周血管功能障碍并不总是引发外周神经功能障碍。这些发现得出结论，对机械刺激的SERs在职业性振动病患者外周神经功能障碍的诊断中比电刺激的SERs更有用。这些发现表明，对手臂进行热水和冷水浸泡以及压迫上臂对职业性振动病患者和平地机驾驶员是有用的感觉测试。
