甲钴胺联合α硫辛酸治疗糖尿病周围神经病变神经电生理分析

目的探讨甲钴胺联合a硫辛酸治疗糖尿病周围神经病变的神经电生理改变。方法 60例糖尿病周围神经病变患者随机分为治疗组和对照组各30例,治疗组给予甲钴胺联合a硫辛酸治疗;对照组给予甲钴胺治疗。比较2组治疗前后运动神经传导速度(MCV)、感觉神经传导速度(SCV)、交感皮肤反应(SSR)潜伏期和波幅(LAT、AMP)的变化。结果 2组治疗后正中神经和腓总神经的MCV、正中神经和腓肠神经的SCV均高于治疗前,且治疗组高于对照组,差异有统计学意义(P0.05);交感皮肤反应2组上肢波幅均高于治疗前,差异有统计学意义(P0.05)。结论甲钴胺联合a硫辛酸治疗糖尿病周围神经病变疗效显著,值得临床使用。     

甲钴胺联合还原型谷胱甘肽治疗慢性酒精中毒性周围神经病疗效观察

目的观察甲钴胺联合还原型谷胱甘肽治疗慢性酒精中毒性周围神经病(CAPN)的临床效果。方法将本院神经内科就诊的52例CAPN患者随机分为治疗组和对照组,治疗组在常规治疗的基础上,给予甲钴胺500μg.d-1肌注,连用4周,同时静脉滴注还原型谷胱甘肽1200 mg.d-1,连续4周;对照组给予肌肉注射维生素,Vit B1100 mg.d-1、Vit B12500μg.d-1,共4周。比较两组治疗前后症状、体征及运动和感觉神经传导速度(MCV、SCV)的变化。结果与对照组比较,治疗组临床症状和体征明显改善,总有效率高于对照组(P<0.05),MCV和SCV有显著提高(P<0.05)。结论甲钴胺联合还原型谷胱甘肽能改善慢性酒精中毒性周围神经病患者的临床症状,提高神经传导速度(NCV),疗效确切。     

凯时与赛莱乐联合治疗糖尿病周围神经病变临床观察

目的观察凯时与赛莱乐联合治疗糖尿病周围神经病变的临床疗效。方法选择确诊的56例2型糖尿病患者合并皮肤感觉异常,四肢麻木,疼痛及走路不稳或活动受限,肌电图显示神经传导功能障碍;排除其他原因所致周围神经病变的患者。随机分为治疗组30例,对照组26例。均以饮食及胰岛素控制血糖,治疗组凯时10μg,赛莱乐200mg各加入生理盐水250ml静滴,1次/d,2周为1疗程。对照组给予维生素B1100mg,维生素B6100mg,维生素B121000μg,香丹注射液20ml静滴,1次/d,共2周。观察2组治疗前后症状改善情况并用肌电图测正中神经、腓神经的运动传导速度(MCV)及感觉传导速度(SCV)。结果2组用药后自觉症状均有所改善,治疗组明显优于对照组;正中神经、腓神经的运动传导速度及感觉传导速度均有所改善,但治疗后治疗组明显优于对照组,治疗组总有效率93.3%,对照组总有效率69.2%,2组疗效比较差异有显著性(P<0.01)。结论凯时联合赛莱乐治疗糖尿病周围神经病变是一种有效的方法。     

神经传导速度检测诊断酒精性周围神经病的价值

目的探讨神经传导速度(NCV)对慢性酒精中毒性周围神经病(CAPN)的诊断价值。方法采用肌电图检测52例CAPN患者的正中神经、尺神经、腓神经和胫神经的NCV,并与26例健康者进行对照比较。结果CAPN患者的NCV异常率为73.12%,明显高于对照组;下肢NCV异常率(80.77%)高于上肢异常率(76.47%);感觉神经传导速度(SCV)异常率(82.73%)高于运动神经传导速度(MCV)异常率(75.26%)。结论NCV检测可作为酒精中毒性周围神经病的方法之一。     

前列腺素E_Ⅰ治疗糖尿病周围神经病变对神经传导速度的影响观察

目的观察前列腺素E_Ⅰ治疗糖尿病周围神经病变的疗效及对神经传导速度的影响。方法选择我院2013-05—2015-05收治的93例糖尿病周围神经病变患者为研究对象,分为2组。对照组单纯应用甲钴铵,治疗组在对照组基础上应用前列腺素E_Ⅰ。比较2组治疗前后正中神经与腓总神经的运动传导速度(MCV)与感觉传导速度(SCV)、治疗总有效率及不良反应发生率。结果 2组治疗前正中神经与腓总神经MCV与SCV的比较差异均无统计学意义(P0.05);经治疗后,治疗组各项指标均高于对照组,比较差异有统计学意义(P0.05)。治疗组总有效率为89.4%(42/47),明显高于对照组71.7%(33/46),差异有统计学意义(P0.05)。治疗组不良反应发生率为6.4%(3/47),与对照组4.4%(2/46)相比差异无统计学意义(P0.05)。结论前列腺素EⅠ治疗糖尿病周围神经病变疗效显著,可显著提高神经传导速度,安全性高,值得推广应用。     

硫辛酸注射液对糖尿病周围神经病变的疗效观察

目的观察硫辛酸注射液对糖尿病周围神经病变的疗效。方法入选76例,随机分为治疗组40例,对照组36例。对照组给予维生素B12注射液500μg肌内注射,1次/d,疗程2周;治疗组给予硫辛酸注射液600mg静滴,1次/d,疗程2周。结果 2周治疗后,治疗组有效率高于对照组,差异有统计学意义(P<0.05);治疗组正中神经和腓总神经的传导速度较治疗前有明显改善,与对照组相比,差异有统计学意义(P<0.05)。结论硫辛酸注射液能明显改善糖尿病周围神经病变患者的症状,有应用价值。     

甲钴胺联合神经节苷酯治疗慢性酒精中毒性周围神经病的临床分析

目的观察甲钴胺联合单唾液酸四己糖神经节苷酯(神经节苷酯)治疗慢性酒精中毒性周围神经病(CAPN)的临床疗效。方法选取48例确诊为慢性酒精中毒性周围神经病患者,随机分成治疗组和对照组,对照组给予甲钴胺及常规药物治疗,治疗组在此基础上加用神经节苷酯,治疗4周后的临床疗效采用症状体征和神经传导速度进行评价。结果治疗组总有效率为91.7%,对照组总有效率66.7%,治疗组总有效率比对照组高,差异有统计学意义(P0.05)。两组患者治疗后的正中神经和腓总神经的神经传导速度都有增加,治疗组比对照组增加更明显,差异有统计学意义(P0.05)。结论甲钴胺联合神经节苷脂治疗慢性酒精中毒性周围神经病变可显著改善患者的症状体征和神经传导速度,值得临床推广应用。     

硫辛酸对慢性酒精性周围神经病炎性因子及临床症状的影响

目的观察硫辛酸对慢性酒精性周围神经病(CAPN)患者的炎性因子及临床症状的影响。方法将宝鸡市中心医院神经内科就诊的42例CAPN患者随机分为治疗组和对照组,每组21例。治疗组给予硫辛酸静脉滴注,0.6 g/d;对照组给予甲钴胺注射液避光静脉滴注,500μg/d,两组均连用2周为一疗程。比较两组患者治疗前与治疗后肿瘤坏死因子-α(TNF-α)及白介素-6(IL-6)的变化,并观察两组患者治疗后临床症状改善情况。结果治疗后2组患者TNF-α及IL-6水平与治疗前比较明显降低,差异有统计学意(P0.05);治疗组TNF-α及IL-6水平显著低于对照组,差异有统计学意义(P0.05)。治疗后两组临床症状评分与治疗前比较均降低,差异有统计学意义(P0.05);治疗组临床症状评分明显低于对照组,差异有统计学意义(P0.05)。结论硫辛酸可降低CAPN患者炎性因子的表达,显著改善患者的临床症状,值得临床进一步推广应用及研究。     

硫辛酸对慢性酒精性周围神经病同型半胱氨酸、超敏C反应蛋白及临床症状的作用

目的观察硫辛酸对慢性酒精性周围神经病(CAPN)的同型半胱氨酸(HCY)、超敏C反应蛋白(Hs-CRP)及临床症状的作用。方法将46例CAPN患者随机分为治疗组和对照组,治疗组给予硫辛酸静脉滴注,0.6 g/d;对照组给予甲钴胺注射液避光静脉滴注500 ug/d,连用14 d,比较两组患者治疗前、治疗后HCY及HsCRP及变化,并以神经系统症状评分,以评价其疗效。结果治疗后2组患者HCY及Hs-CRP水平明显降低,与治疗前比较,差异有统计学意(P0.05),且治疗组Hs-CRP及Hs-CRP水平显著低于对照组,差异有统计学意义(P0.05);治疗后两组临床症状评分均降低,与治疗前比较,差异有统计学意义(P0.05),且治疗组临床症状评分显著低于对照组,差异有统计学意义(P0.05)。治疗期间2组患者均未出现明显不良反应。结论硫辛酸可降低CAPN患者HCY及Hs-CRP水平,显著改善患者临床症状,值得应用及研究。     

α-硫辛酸 甲钴胺与前列腺素E1治疗糖尿病周围神经病变的疗效观察

目的探讨α-硫辛酸、甲钴胺与前列腺素E1治疗糖尿病周围神经病变(DPN)的临床疗效。方法选取我院2012-01—2013-12收治的DPN患者74例,随机分为2组,均给予控制血糖、血压、血脂,合理饮食等基础治疗,对照组在上述治疗措施基础上给予甲钴胺1mg加入生理盐水100mL中静滴,1次/d;前列腺素E1 10μg加入生理盐水100mL静滴,1次/d。观察组在对照组治疗的基础上加用α-硫辛酸600mg加入生理盐水250mL中静滴,1次/d,连用2周。观察治疗前后2组神经病变主觉症状问卷(TSS)评分、运动(MNCV)和感觉神经传导速度(SNCV)、神经缺陷评分(NDS),对比2组疗效。结果2组治疗后TSS评分均显著降低,观察组降低更为显著,差异有统计学意义(P0.05);2组治疗后正中神经、腓总神经MNCV和SNCV均明显增加,但观察组变化更为明显,差异有统计学意义(P0.05)。观察组临床总有效率明显高于对照组(P0.05)。结论α-硫辛酸联合甲钴胺与前列腺素E1治疗DPN可有效改善患者临床症状,明显提高神经传导速度,疗效确切,安全性较高,值得临床推广。     

冬季皮肤温度变化对周围神经传导速度的影响及护理干预

目的:通过控制皮肤温度从而提高肌电图检查中周围运动神经传导速度(MCV)和感觉神经传导速度(SCV)的精确性.方法:随机选择20名医务工作志愿者且肌电图检查无周围神经MCV及SCV异常者为研究对象,在行肌电图MCV和SCV检查的同时进行皮肤温度检测.实验组10名(皮肤度控制在20℃左右);对照组10名(皮肤温度控制在3...     

慢性酒精性多发性神经病的临床、病理及电生理特征

报告３５例慢性酒精性多发性神经病患者，全部为男性，年龄３３～７０岁，平均５３．７岁。主要临床症状是四肢疼痛、麻木，袜套－手套式痛温觉减退，震动党消失和肌肉萎缩。运动神经和感觉神经传导速度均有不同程度的减慢。腓浅神经活检见有髓神经纤维髓鞘变性，轴索变性或消失。Ｓｃｈｗａｎｎ细胞变性，也累及神经束膜。此种改变来源于长期饮酒所引起的维生素缺乏所致。     

Nerve conduction defects are retarded by tight metabolic control in type I diabetes

This follow-up study examines whether the development of nerve dysfunction is retarded by tight metabolic control in patients with type I diabetes mellitus. Seventy-one patients and 115 age-matched healthy control subjects underwent studies of nerve conduction in peroneal and sural nerves. The presence of diabetes was associated with a reduction in peroneal motor nerve conduction velocity (MCV) by 5.9 m/s, sural sensory nerve conduction velocity (SCV) by 3.4 m/s, and sural sensory nerve action potential (SNAP) amplitude by 22%. Dysfunction in peroneal MCV, sural SCV, and sural SNAP were related to long-term poor metabolic control. Eleven of 12 patients with HbA1c <6.5% had normal nerve conduction or abnormality in only one nerve as compared to 2 of 15 patients with HbA1c >8.0%. It is concluded that tight long-term metabolic control (HbA1c <6.5%) can retard nerve dysfunction in patients with type I diabetes mellitus and a mean disease duration of 12 years.     

F-wave latency,the most sensitive nerve conduction parameter in patients with diabetes mellitus

In this study we examined the diagnostic sensitivity of minimal F-wave latency, F-wave persistence, motor nerve conduction velocity (MCV), and amplitude of the compound motor action potential (CMAP) of the median, ulnar, tibial, and peroneal nerves, and of sensory conduction velocity (SCV) and sensory nerve action potential (SNAP) amplitude of the sural nerve in 82 diabetic patients. For the median, ulnar, and tibial nerves the Z scores of the minimal F-wave latency were significantly larger than those of the MCV, and for all four motor nerves the Z scores of the minimal F-wave latency were significantly larger than those of the amplitude of the CMAP. The Z scores of the peroneal minimal F-wave latency exceeded those of peroneal MCV, sural SCV, and sural SNAP. F-wave persistence did not differ significantly from the reference values. In conclusion, minimal F-wave latency is the most sensitive measure for detection of nerve pathology and should be considered in electrophysiological studies of diabetic patients. © 1997 John Wiley & Sons, Inc. Muscle Nerve 20: 1296–1302, 1997     

糖尿病周围神经病病情分级与电生理的相关性

目的探讨糖尿病周围神经病病情分级与电生理的相关性。方法依据糖尿病性周围神经病的诊断标准确定入选对象;依据糖尿病周围神经病病情分级对入选对象进行临床分级;应用丹麦产DANTEC CANTATA型肌电图仪,进行运动神经和感觉神经传导功能检查。结果腓肠神经、正中神经诱发感觉动作电位波幅(SNAP)和腓总神经复合肌肉动作电位波幅(CMAP)随病情分级的升高而明显减低(P<0.05);腓肠神经、正中神经感觉传导速度(SCV)和腓总神经、正中神经运动传导速度(MCV)3级与1、2两级比较显著减慢(P<0.05)。结论神经电生理改变,尤其感觉神经电生理改变,易此作为糖尿病周围神经病情程度评定的指标。     

Is Ross syndrome a dysautonomic disorder only? An electrophysiologic and histologic study.

OBJECTIVE: To define the involvement of peripheral nerve fibers in Ross syndrome. METHODS: Mechanical pain perception, tactile and thermal thresholds on hand, foot dorsum, thigh, median nerve orthodromic sensory conduction velocity (SCV) and motor conduction velocity (MCV), sural nerve antidromic SCV, peroneal nerve MCV, H-reflex, F-wave, median, tibial nerve somatosensory evoked potentials (SSEPs), perioral, hand CO(2) laser late (LEPs) and ultralate evoked potentials, sympathetic skin response (SSRs), cardiovascular, Minor sweat, silastic imprint, histamine, photopletysmographic and pupil pilocarpine tests, cutaneous innervation immunohistochemical techniques were studied in 3 patients with Ross syndrome. RESULTS: Quantitative sensory testing showed altered results in patients 1 and 2, and patient 3 had a slight impairment of mechanical pain perception. Nerve conduction, except for a median nerve distal reduction of sensory conduction in patient 1, F-wave and SSEP findings were normal; H-reflex was absent at rest in all patients. Hand LEPs were absent in patient 2, ultralate potentials were absent in patients 1 and 2. Skin biopsy showed a disease duration related reduction of unmyelinated and myelinated sensory fibers and a lack of unmyelinated autonomic fibers in all patients. CONCLUSIONS: Our data suggest that Ross syndrome is a degenerative disorder involving progressive sudomotor fibers, and then epidermal sensory unmyelinated and myelinated fibers.     

Peripheral motor and sensory nerve conduction studies in normal infants and children.

OBJECTIVE: There are few data on electrophysiological data of motor and sensory fibres during nerve maturation. The aim of this study is to investigate the evolution of nerve conduction in the upper and lower limbs during the first years of life. METHODS: The study comprised 92 normal infants and children aged from 1 week to 6 years. Using surface electrodes, the investigation included the following data: (1) motor conduction velocity (MCV), corrected distal motor latency (DML) to a standard distance, and F-waves of the median, ulnar, peroneal and tibial nerves; (2) sensory conduction velocity (SCV) of the median and tibial nerves; and (3) amplitude and morphology of the muscle and sensory action potentials. RESULTS: Maximal MCV and SCV in the neonatal period was about half of adults; there was a steep conduction increase during the first year of life, adult values being reached around age 4. In the neonatal period corrected DML was greater than in adults with a further decrease during the first year. F-wave latencies also decreased during the first year with increase at the end of the study. CONCLUSIONS: This study corroborates the fact that 'maturation' of MCV and SCV occurs during the first 5 years of life, especially in the former. Evolution of DML is accounted for using correction. F-wave latency changes are explained both by an increase in MCV, and extremity growth.     

定量感觉检查及神经传导速度测定对多发性神经病的诊断价值

目的探讨定量感觉检查(QST)及其联合神经传导速度(NCV)测定对多发性神经病的诊断价值。方法对60例多发性神经病患者进行QST以及感觉神经传导速度(SCV)、运动神经传导速度(MCV)检测,并比较各项检查的异常率。结果 QST的异常率(83.3%)显著高于SCV和MCV(50.0%,26.7%)(均P<0.05);SCV的异常率显著高于MCV(P<0.05)。QST联合SCV的异常率为95.0%,显著高于MCV的异常率(P<0.05)。结论 QST对多发性神经病的检出率较高,QST联合SCV对多发性神经病具有很高的诊断价值。     

糖尿病周围神经病电生理特点及与血糖水平的关系

目的研究糖尿病周围神经病的神经电生理特点以及与血糖水平的关系。方法分析2013年3月~2014年3月于本院神经内科住院的108例糖尿病周围神经病患者,测定其正中、尺、胫、腓总神经的运动传导速度(MCV)和复合肌肉动作电位波幅(CMAP),以及正中、尺、腓肠神经、腓浅神经的感觉传导速度(SCV)和感觉神经动作电位波幅(SNAP),比较上、下肢和运动、感觉神经异常情况,分析糖化血红蛋白(HbA1C)、餐后2 h血糖对神经传导速度(NCV)的影响。结果糖尿病患者下肢运动神经病变重于上肢,且差异明显(P<0.05)。感觉神经损害重于运动神经,且差异明显(P