CAJ | 학술논문

目的了解pSS合并周围神经病变的患病率及其临床、实验室特点.方法入选符合2002年国际分类标准的pSS患者52例,选择同期我院体检中心健康体检者25名为健康对照组,所有的研究对象均行四肢神经传导(NCV)检查,了解pSS相关周围神经病变的患病率,并对pSS患者的临床及实验室特点进行分析.数据分析采用t检验、x2检验、Fisher确切概率法.结果 pSS患者中NCV异常检出率79％(41/52),而健康对照组仅12％(3/25),2组间差异有统计学意义(x2=30.8,P＜0.01).pSS患者的周围神经病变症状多样,其中无症状患者达37％(15/41).受累神经按频次依次见于正中神经(30例)、尺神经(24例)、胫神经(18例)、腓总神经(12例)、腓浅神经(10例);神经病变类型以单纯感觉神经病变最常见(20例),其次为感觉运动神经混合病变(14例);感觉神经以髓鞘病变为主(31例),而运动神经则以轴突病变多见(18例).NCV异常与NCV正常的pSS患者的发病年龄、病程、欧洲抗风湿联盟SS疾病活动度评分(ESSDAI)及临床与实验室特征(除感觉异常、运动障碍外)差异均无统计学意义(P＞0.05).结论 pSS合并周围神经病变常见,且临床表现和电生理特征呈多样性;对pSS患者常规进行电生理检测,不失为提高周围神经病变检出率的有效方法.
목적 료해pSS합병주위신경병변적환병솔급기림상、실험실특점.방법 입선부합2002년국제분류표준적pSS환자52례,선택동기아원체검중심건강체검자25명위건강대조조,소유적연구대상균행사지신경전도(NCV)검사,료해pSS상관주위신경병변적환병솔,병대pSS환자적림상급실험실특점진행분석.수거분석채용t검험、x2검험、Fisher학절개솔법.결과 pSS환자중NCV이상검출솔79％(41/52),이건강대조조부12％(3/25),2조간차이유통계학의의(x2=30.8,P＜0.01).pSS환자적주위신경병변증상다양,기중무증상환자체37％(15/41).수루신경안빈차의차견우정중신경(30례)、척신경(24례)、경신경(18례)、비총신경(12례)、비천신경(10례);신경병변류형이단순감각신경병변최상견(20례),기차위감각운동신경혼합병변(14례);감각신경이수초병변위주(31례),이운동신경칙이축돌병변다견(18례).NCV이상여NCV정상적pSS환자적발병년령、병정、구주항풍습련맹SS질병활동도평분(ESSDAI)급림상여실험실특정(제감각이상、운동장애외)차이균무통계학의의(P＞0.05).결론 pSS합병주위신경병변상견,차림상표현화전생리특정정다양성;대pSS환자상규진행전생리검측,불실위제고주위신경병변검출솔적유효방법.
Objective To investigate the prevalence of peripheral neuropathy (PN) associated with primary Sj(o)gren's syndrome (pSS),and to describe the clinical and laboratory features of pSS patients with PN.Methods Fifty-two patients who fulfilled the 2002 American-European Consensus Group criteria for pSS were enrolled into the study.Twenty-five healthy persons from Physical Examination Center of our hospital during the same period served as the normal control group.All subjects underwent limb nerve conduction velocity (NCV) examination to investigate the prevalence of pSS related PN.And the clinical and laboratory features of pSS were collected and analyzed.Data were analyzed by t test,x2 test,Fisher exact probability test.Results The NCV abnormal rate was 79％(41/52) in pSS patients,while the control group was only 12％(3/25),there was significant difference between the two groups (x2=30.8,P＜0.01).The clinical spectrum of peripheral neuropathies encountered in pSS was wide,including asymptomatic patients which up to 37％(15/41).The involved nerve according to frequencies were found in the median nerve (30 cases),ulnar nerve (24 cases),tibial nerve (18 cases),common peroneal nerve (12 cases) and superficial peroneal nerve (10 cases).The type of neuropathy with pure sensitive abnormality was the most common,followed by mixed sensory and motor nerve lesions.Myelin lesions were most likely involved in sensory neuropathies,while axon lesions were in motor neuropathies.The age of onset,course of disease,disease activity index of ESSDAI and the clinical and laboratory features (except paresthesia/movement barrier) showed no significant difference (P＞0.05) between the two groups of pSS patients with NCV abnomality and NCV normal.Conclusion Peripheral neuropathy is not a rare manifestation of pSS,and it's clinical and electrophysiological spectrum is wide.Routinely carrying out electrophysiological examination on pSS patients is an effective method to improve the detection rate of PN.