CAJ | 학술논문

目的：探讨联邦止咳露依赖并发周围神经损害的临床表现及治疗。方法：通过患者的临床表现、肌电图、肌肉活检、腓肠神经活检结果展开临床诊断及机制分析。结果：患者长期饮用联邦止咳露致药物依赖。肌电图提示周围神经神经原性损害。肌肉活检显示肌纤维损害及少量的单核和淋巴细胞浸润。电镜下肌小节结构模糊，线粒体空泡样变。神经活检部分有髓神经纤维肿胀，板层结构松散，成剥离的洋葱皮样结构，轴索被破坏。免疫荧光染色显示轴索破坏、髓鞘变薄。结论：联邦止咳露依赖可伴发周围神经损害，在戒瘾同时予B族维生素治疗后症状缓解。
목적：탐토련방지해로의뢰병발주위신경손해적림상표현급치료。방법：통과환자적림상표현、기전도、기육활검、비장신경활검결과전개림상진단급궤제분석。결과：환자장기음용련방지해로치약물의뢰。기전도제시주위신경신경원성손해。기육활검현시기섬유손해급소량적단핵화림파세포침윤。전경하기소절결구모호，선립체공포양변。신경활검부분유수신경섬유종창，판층결구송산，성박리적양총피양결구，축색피파배。면역형광염색현시축색파배、수초변박。결론：련방지해로의뢰가반발주위신경손해，재계은동시여B족유생소치료후증상완해。
Objective: To explore the clinical manifestations and treatment of peripheral nerve injury attributed to anticol cough syrup abuse. Methods: Clinical manifestations, as well as laboratory examinations, including electromyography, muscle biopsy and sural nerve biopsy were analyzed, whereby clinical diagnosis and the underlying mechanism were assessed. Results: The patients showed the drug dependence caused by long time anticol cough syrup abuse. Electromyography indicated the obvious features of peripheral neurogenic injury. Muscle biopsy revealed that the damage of muscle fibers and scattered lymphocytes and monocytes infiltration, ultrastructural changes included the cloudy structure of sarcomere and the vacuolar degeneration of mitochondria. Nerve biopsy indicated the swollen myelinated fibre loose lamellar structure and damaged axon in sural nerve. Immunofluorescent staining further confirmed the destroyed axon and thinning myelin. Conclusion: Anticol cough syrup abuse may cause peripheral nerve injury. In addition to drug treatment, the symptoms could be alleviated by Vitamin B administration.