尿毒症性周围神经病的特点与生活质量评价

目的：探讨尿毒症性周围神经病的特点并对其生活质量评价。方法：收集我院2011年1月～2011年6月278例维持性血透治疗的尿毒症患者,据其是否存在周围神经病变分成病变组（110例）与非病变组（168例）。了解病变组症状体征的变化,通过肌电图检测受检神经的感觉神经传导速度（SCV）、运动神经传导速度（MCV）及末端潜伏期（ML）,并采用SF-36量表对其生活质量进行评价。结果：病变组出现四肢远端的麻木与烧灼感,其上、下肢分别占3.6%（4/110）和48.2%（53/110）;运动症状表现为上、下肢无力,分别占1.8%（2/110）和11.8%（13/110）;体征的改变主要表现在腱反射,上肢腱反射减退和消失占9.09%（10/110）,膝腱反射减退和消失占55.45%（61/110）,跟腱反射减退和消失占35.5%（39/110）。病变组受检神经的平均SCV和MCV减慢,平均ML延长,与非病变组比较差异存在统计学意义（P均〈0.01）,病变组SF-36量表中的各项得分均低于对照组,但总分较非病变组差异无统计学意义（t=1.896,P=0.060）,仅在躯体疼痛方面差异存在统计学意义（t=5.301,P〈0.001）。结论：尿毒症性周围神经病常见的症状为四肢麻木,体征为腱反射的改变,感觉神经受损重于运动神经,下肢病变较上肢严重。尿毒症性周围神经病变患者生活质量差,临床医师需予以足够重视,不断改善其预后及生活质量。

Characteristics and Quality of Life Evaluation of Uremic Peripheral Neuropathy

Objective:To investigate the characteristics of patients with uremic peripheral neuropathy and evaluation of their quality life.Methods:278 cases of uremia undergoing hemodialysis treatment were collected in our hospital from January 2011 to June 2011.According to whether the existence of peripheral neuropathy,they were divided into the lesion group(110 cases)and non-lesion group(168 cases).To understand the changes of the signs and symptoms of the disease group,the EMG was used to detect sensory nerve conduction velocity(SCV),motor nerve conduction velocity(MCV)and distal latency(ML).SF-36 scale was used to evaluate the quality of life.Results:Numbness and burning sensation of the distal limbs appeared in the lesions group,with its upper and lower limbs accounted for 3.6%(4/110)and 48.2%(53/110);On the performance of the motor symptoms of lower limb weakness,respectively,accounted for 1.8%(2/110)and 11.8%(13/110);Signs of change in the tendon reflexes and upper extremity tendon reflexes disappearing accounted for 9.09%(10/110);Knee tendon reflex loss and disappearance was accounting for 55.45%(61/110),and Achilles tendon reflex loss and disappearance 35.5%(39/110).Average subjects nerve SCV and MCV were slowing down and the average ML extending,with a significant difference(P<0.01)in lesion group compared with non-lesion group.SF-36 score in the lesions group was lower than the control group,but the total score was not statistically different than the non-lesion group(t=1.896,P=0.060),only a statistical difference in bodily pain(t=5.301,P<0.001).Conclusion:The common symptoms of uremic peripheral neuropathy were numbness of the limbs and signs for the change of the tendon reflexes.Sensory nerve damage was more severe than the motor nerve,with lower extremity lesions more severe than upper limb.Clinicians need to pay sufficient attention to quality of life for patients with uremic peripheral neuropathy,and constantly improve the prognosis and quality of life.