CAJ | 학술논문

目的通过皮肤交感反应(SSR)的变化探讨慢性正己烷中毒对自主神经功能的影响.方法将我院收治的37例职业性慢性正己烷中毒患者按照职业病诊断结果分为轻、中、重度中毒组,并选择30例健康对照组,做SSR及神经传导速度(NCV)检查.中毒组每l～2个月复查1次,观察各组SSR参数(潜伏期、波幅)的差异及重度中毒组SSR参数与NCV参数(传导速度、波幅)随病程动态演变的关系.结果各组上肢SSR潜伏期及各组上、下肢SSR波幅的差异有统计学意义(P＜0.05),相邻两组SSR参数比较,差异无统计学意义(P＞0.05)；各组上肢SSR潜伏期及上、下肢SSR波幅在不同病程差异有统计学意义(P＜0.05)；SSR参数与神经传导速度动态变化一致；上肢SSR最长潜伏期及上、下肢SSR最低波幅较动作电位最低波幅要提早1～2个月出现.结论正己烷对自主神经损害程度随着中毒程度的加重而加重.自主神经损害与大纤维的髓鞘损害动态演变符合,和大纤维的轴索损害比较,时间提早1～2个月.SSR检查可以作为慢性正己烷中毒自主神经功能损害客观检查的方法之一.
목적 통과피부교감반응(SSR)적변화탐토만성정기완중독대자주신경공능적영향.방법 장아원수치적37례직업성만성정기완중독환자안조직업병진단결과분위경、중、중도중독조,병선택30례건강대조조,주SSR급신경전도속도(NCV)검사.중독조매l～2개월복사1차,관찰각조SSR삼수(잠복기、파폭)적차이급중도중독조SSR삼수여NCV삼수(전도속도、파폭)수병정동태연변적관계.결과 각조상지SSR잠복기급각조상、하지SSR파폭적차이유통계학의의(P＜0.05),상린량조SSR삼수비교,차이무통계학의의(P＞0.05)；각조상지SSR잠복기급상、하지SSR파폭재불동병정차이유통계학의의(P＜0.05)；SSR삼수여신경전도속도동태변화일치；상지SSR최장잠복기급상、하지SSR최저파폭교동작전위최저파폭요제조1～2개월출현.결론 정기완대자주신경손해정도수착중독정도적가중이가중.자주신경손해여대섬유적수초손해동태연변부합,화대섬유적축색손해비교,시간제조1～2개월.SSR검사가이작위만성정기완중독자주신경공능손해객관검사적방법지일.
Objective To study the sympathetic skin response (SSR) to the effects of N-hexane on autonomic nerves function in patients with chronic N-hexane poisoning,Methods The subjects in present study included 30 controls and 37 cases with chronic N-hexane poisoning.Also 37 patients were divided into 3 subgroups (mild,moderate and severe poisoning) according to diagnostic criteria of occupational diseases.All subjects were examined by SSR test and nerve conduction velocity (NCV) test.All patients were reexamined by SSR and N CV every 1-2 months.The differences in SSR parameters (latency,amplitude)among groups were observed.In the severe poisoning subgroup,the changes of SSR and NCV parameters (conduction velocity,amplitude)in different poisoning stages were observed.Results There were significant differences in SSR latency of upper extremity among groups and the significant differences in SSR amplitude of upper and lower extremity among groups (P＜0.05).No significant differences in SSR parameters were found between the adjacent groups (P＞0.05),There were significant differences in SSR latency of upper extremity during different periods and the significant differences in SSR amplitude of upper and lower extremity during different periods among all groups (P＜0.05).The change of SSR parameters consistent with that in NCV.The longest SSR latency of upper extremity and the smallest SSR amplitudes of upper and lower extremity appears 1-2 months earlier than that of the smallest action potential amplitude.Conclusion The damage of autonomic nerves induced by N-hexane increased with poisoning progresses.The damage of autonomic nerves corresponded with the damage of myelin sheath of large myelinated nerves,but which appeared 1-2 months earlier than the damage of axon of large myelinated nerves.SSR test may serve as a method to detect the damage of autonomic nerves function in patients with chronic N-hexane poisoning.