POEMS综合征患者神经电生理特点研究

目的研究POEMS综合征的神经电生理特点。方法分析16例POEMS综合征患者医疗及神经传导记录,共检测92根运动神经和58根感觉神经。结果复合肌肉动作电位(CMAP)和感觉神经动作电位(SNAP)在下肢比上肢更不易被引出(包括运动和感觉神经,P<0.05)。CMAP波幅下肢比上肢降低更明显(P<0.05)。运动神经(94%)和感觉神经(78%)传导速度减慢较常见。70%的运动神经远端运动潜伏期(DML)延长,患者的远端潜伏期指数(TLI)较正常值明显升高(P<0.05)。结论 POEMS综合征患者的神经电生理结果存在特征性表现,传导异常较常见,下肢受累更严重,在神经的中间部分比远端部分表现更突出,可以对早期诊断POEMS综合征提供帮助。

Electrophysiological Features of Patients with POEMS Syndrome

Objective To summarize the electrophysiological features of POEMS syndrome.Methods We reviewed the medical records and nerve conduction studies(NCS)of 16 consecutive patients with POEMS syndrome.A total of 92 motor and 58 sensory nerves were examined.Results Compound muscle action potentials(CMAP)and sensory nerve action potentials(SNAP)were not elicited in lower limbs more frequently compared with in upper limbs(P<0.05,in both motor and sensory nerves),and the CMAP amplitude was more attenuated in lower limbs than in upper limbs(P<0.05).Abnormal conduction slowing was frequently observed in motor and sensory nerves.Distal motor latencies were abnormally prolonged in 70% of the motor nerves,and terminal latency indices(TLI) were significantly higher in patients than in normal controls(P<0.05).Conclusion Patients with POEMS syndrome have characteristic features.Conduction abnormalities are more frequently and severely affected in the lower limbs,and more predominant in the intermediate nerve segments than in the distal portions.