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肝硬化患者振动觉和温度觉外周感觉的改变

Alterations of vibratory and thermal peripheral sensitivity in liver cirrhosis.

作者信息

Gentile S, Marmo R, Orlando C, Peduto A, Montella F, Coltorti M

机构信息

Istituto di Medicina Generale, Facoltà di Medicina II, Università di Napoli, Italy.

出版信息

Ital J Gastroenterol. 1993 Jul;25(6):307-13.

PMID:8400366
Abstract

Peripheral neurological involvement, causing distal paresthesias and/or cramps has been described in liver cirrhosis, and its symptoms are quite frequent in decompensated patients under diuretic treatment. In this paper we reported thermal (TPT) and vibratory (VPT) sensations in 100 well-defined cirrhotics (43 in group A, and 63 in B and C of Child-Pugh classification) to define the prevalence of such alterations and the role of sex, age, severity and aetiology of the cirrhosis, and diuretic treatment. The TPT and VPT values were out of the normal range in 28% and 39% of the patients, respectively. Significantly, the alteration of VPT was associated both to alcoholic aetiology and decompensated cirrhosis, whereas the only parameter significantly associated to TPT alterations was alcoholic aetiology. Multiple factors such as inappropriate nutrition, hypercatabolic status, and portal systemic shunting may play a role in inducing trophic disturbances of nervous fibres in cirrhotics.

摘要

肝硬化患者存在周围神经受累,可导致远端感觉异常和/或痉挛,在接受利尿剂治疗的失代偿期患者中,这些症状相当常见。在本文中,我们报告了100例明确诊断的肝硬化患者(根据Child-Pugh分类,A组43例,B组和C组63例)的温度觉阈值(TPT)和振动觉阈值(VPT),以确定此类改变的发生率以及性别、年龄、肝硬化严重程度和病因以及利尿剂治疗的作用。TPT和VPT值分别在28%和39%的患者中超出正常范围。值得注意的是,VPT改变与酒精性病因和失代偿期肝硬化均相关,而与TPT改变显著相关的唯一参数是酒精性病因。营养不良、高分解代谢状态和门体分流等多种因素可能在导致肝硬化患者神经纤维营养障碍中起作用。

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