Margherita A J, Robinson L R, Heimbach D M, Fishfader V L, Schneider V A, Jones D
Department of Rehabilitation Medicine, Harborview Medical Center/University of Washington School of Medicine, Seattle 98195.
Am J Phys Med Rehabil. 1995 Jan-Feb;74(1):28-32. doi: 10.1097/00002060-199501000-00005.
This study sought to evaluate the timing of burn-associated polyneuropathy (BAPN) and its relationship to burn severity or size. Seventeen burned subjects were studied 1 wk after thermal burns. Eleven subjects remained in the study to complete 6-wk follow-up studies. Nerve conduction studies were done on at least three nerves in two unburned limbs; results were numerically summarized by calculating Z scores for each parameter. A composite Z score, termed Ztotal, measured global nerve function. One week postburn, motor and sensory distal latencies were prolonged (mean Z, -0.72 and -0.85, respectively), motor conduction velocities slowed (mean Z, -1.31) and sensory nerve action potentials reduced in amplitude (mean Z, -0.66). Associations of Ztotal scores with total burn surface area and depth were not statistically significant. Those with severe neuropathy had higher levels of c-reactive protein (Spearman correlation, -0.624; P = 0.0129). There were no significant changes in Z scores at 6 wk. We conclude that BAPN is common after thermal injury, and the electrophysiologic manifestations of BAPN are present within the first week. Thermal injuries may induce an inflammatory cascade that results in alterations of nerve function.
本研究旨在评估烧伤相关性多发性神经病（BAPN）的发生时间及其与烧伤严重程度或面积的关系。对17名热烧伤患者在烧伤后1周进行了研究。11名患者继续参与研究以完成6周的随访研究。对两个未烧伤肢体的至少三条神经进行了神经传导研究；通过计算每个参数的Z分数对结果进行了数值汇总。一个称为Ztotal的综合Z分数用于衡量整体神经功能。烧伤后1周，运动和感觉远端潜伏期延长（平均Z值分别为-0.72和-0.85），运动传导速度减慢（平均Z值为-1.31），感觉神经动作电位幅度降低（平均Z值为-0.66）。Ztotal分数与烧伤总面积和深度之间的关联无统计学意义。患有严重神经病的患者C反应蛋白水平较高（Spearman相关性为-0.624；P = 0.0129）。6周时Z分数无显著变化。我们得出结论，热损伤后BAPN很常见，且BAPN的电生理表现出现在第一周内。热损伤可能引发炎症级联反应，导致神经功能改变。
