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保守治疗(未透析)或接受透析治疗患者的尿毒症性多发性神经病

[Uremic polyneuropathy in patients treated conservatively (nondialyzed) or treated with dialysis].

作者信息

Pietrzak I, Czarnecki R, Baczyk K, Antoniewicz K

机构信息

Z Kliniki Nefrologii Instytutu Chorób Wewnetrznych Akademii Medycznej, im. Karola Marcinkowskiego w Poznaniu.

出版信息

Przegl Lek. 1996;53(7):544-8.

PMID:8975290
Abstract

Uremic polyneuropathy is a common complication in dialyzed patients (pts). In 37 end stage renal disease (ESRD) pts the electroneurophysiological (ENF) parameters and serum creatinine (Pcr), guanidino compounds (GC) and guanidinosuccinic acid (GSA) levels were studied. There were 21 nondialyzed (ND), 10-hemodialyzed (HD) and 6-intermittently peritoneally dialyzed (IPD) pts. The following ENF parameters on both upper extremities, using method described by Buchtal and Rosenfalck, were performed: sensory nerves (nn.) conduction velocity, amplitude of evoked potential, subjective and objective impulse and motor nerve-conduction velocity. Cr level in serum was measured by enzymatic method, GC-by Rosenberg, Ennor, Morison method, modified by Szczepkowska. GSA isolation was performed by column chromatography. The results indicated disturbances in peripheral nn. function in all studied groups of pts and did not correlate with levels of uremic toxins in serum. However, it does not mean, that sum of the accumulated various toxic metabolites in ESRD pts, does not influence the development of polyneuropathy. The degree of impairment of peripheral nn. conduction in ESRD did not differ significantly between ND and HD or IPD pts. We did not notice, any significant differences in the degree of polyneuropathy in HD or IPD pts.

摘要

尿毒症性多发性神经病是透析患者常见的并发症。对37例终末期肾病(ESRD)患者的神经电生理(ENF)参数以及血清肌酐(Pcr)、胍类化合物(GC)和胍基琥珀酸(GSA)水平进行了研究。其中有21例未透析(ND)患者、10例血液透析(HD)患者和6例间歇性腹膜透析(IPD)患者。采用布赫塔尔和罗森法尔克描述的方法,对双上肢进行了以下ENF参数检测:感觉神经传导速度、诱发电位幅度、主观和客观冲动以及运动神经传导速度。血清肌酐水平采用酶法测定,GC采用经斯切普科夫斯卡修改的罗森伯格、恩诺尔、莫里森法测定。GSA采用柱色谱法分离。结果表明,所有研究组患者的外周神经功能均有紊乱,且与血清中尿毒症毒素水平无关。然而,这并不意味着ESRD患者体内累积的各种有毒代谢产物的总量不会影响多发性神经病的发展。ESRD患者外周神经传导的受损程度在ND患者与HD或IPD患者之间无显著差异。我们未注意到HD或IPD患者在多发性神经病程度上有任何显著差异。

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