交感神经皮肤反应对评价慢性肾功能不全患者植物神经损害的意义

目的:探讨慢性肾功能不全(CRF)患者交感神经皮肤反应(SSR)的变化及其临床意义。方法:对52例CRF患者行SSR检测,并与32例正常对照组比较。结果:CRF组SSR波幅低于正常对照组,潜伏期较对照组延长(P<0.01)。CRF组SSR总异常率为71%,其中上肢异常率为48%,下肢异常率为71%;慢性肾衰早期组16例中7例(44%)SSR异常,慢性肾衰组19例中14例(74%)SSR异常,尿毒症组17例中16例(94%)SSR异常;CRF患者上下肢之间、不同亚组之间SSR异常率比较差异有极显著意义(P<0.01)。CRF组病程和血肌酐水平与SSR潜伏期间的偏相关系数分别为0.4732(P<0.01)和0.3247(P<0.05),而与SSR波幅间的偏相关系数为-0.3173和-0.3062(P均<0.05);年龄与SSR潜伏期偏相关系数为0.0434(P>0.05),与SSR波幅偏相关系数为-0.4445(P<0.01)。结论:SSR的异常反映了CRF患者常合并交感神经损害,且与病程、肾功能损害程度及年龄因素相关,SSR检测可作为评价CRF患者交感神经损害敏感的客观指标。

The value of sympathetic skin response in assessing the impairment of autonomic nerve in patients with chronic renal failure

Objective:To investigate the value of the changes of sympathetic skin response(SSR) in assessment of sympathetic function in patients with chronic renal failure(CRF).Methods:SSR was performed in 52 CRF patients and comparision was made with 32 healthy controls.Results:The amplitude of SSR decreased and the latency was prolonged significantly in the CRF group as compared with the control group(P<0.01).The abnormality rate of SSR in the CRF group was 71%;it was 48%and 71% respectively in the upper limbs and the lower limbs of the CRF group,and 44%,74% and 94% respectively in the early kidney failure group,the kidney failure group and the uremia group.The abnormality rate of SSR among the patients in different stages of the chronic renal failure were significantly diflferent(P<(0.01),)and the difference between the upper lower limbs of the patients,was also significant.The partial correlation coefficient between the course of disease and the latency of SSR,the level of blood creatinine and the latency of SSR;the course of kidney failure and the amplitude of SSR,the level of blood creainine and the amplitude of SSR;the age of the patients and amplitude of SSR,the age of the patients and the latency of SSR were 0.4732(P<0.01),0.3247(P<0.05),-0.3173(P<0.05),(-0.3062)(P<0.05),-0.4445(P<0.01),0.0434(P>0.05) respectively.Conclusions:SSR abnormalities reflect impairments of sympathetic system in the patients with chronic renal failure,and significant correlation were found between the course of kidney failure,the extent of kidney failure,patient age and the SSR abnormalities.SSR can be used as an objective and sensitive index in evaluating the lesions of the sympathetic system in CRF patients.