铅中毒病人周围神经电生理的研究

目的　观察无周围神经病临床症状的铅中毒病人是否存在亚临床周围神经病 ,并为其诊断提供科学依据。方法　随机选择的 30名无周围神经病临床症状的铅中毒病人 (根据GB1 1 5 0 3— 89诊断 )作为铅中毒组 ,测定单侧正中神经、尺神经、胫神经和腓神经运动神经传导速度 (MNCV)和运动神经远端潜伏期(DML)及尿铅。结果　研究组平均MNCV减慢、DML延长 ,与对照组比较差异均有显著性 (P <0 0 1 )。研究组正中神经MNCV减慢与尿铅浓度呈明显负相关 ,r=- 0 6 82 ,P <0 0 5。结论　无周围神经病临床表现的铅中毒病人存在亚临床周围神经病 ,MNCV、DML检查可作为铅中毒亚临床周围神经病的早期诊断指标之一。

Electrophysiological Study on Patients of Lead Poisoning in Absence of Symptoms and Signs of Peripheral Neuropathy

Objective To investigate the possible existence of sub clinical neurological alterations among the lead poisoning patients in absence of symptoms and signs of peripheral neuropathy.Methods The study group consisted of 30 cases of lead poisoning patients in absence of symptoms and signs of peripheral neuropathy.Motor nerve conduction velocities(MNCV),distal latencies(DML)and electromyography(EMG)were studied on 30 cases of lead poisoning patients MNCV and DML of median,ulnar,sual,tibial nerve on one side were determined by standard method.Results The mean MNCV of the median,ulnar,sual,tibial nerve were significantly lower in the lead poisoning group than in the control group(P<0 01).Similarly,the DML of these four nerves were significantly prolonged in the lead poisoning group compared with the control group(P<0 01).In the lead poisoning group,both MNCV decrease and urine lead increase correlated significantly(correlation coefficient is -0 682,P<0 05).Conclusions The results suggested that lead poisoning patients in absence of symptoms and signs of peripheral neuropathy may have sub clinical peripheral neuropathy.MNCV and DML measurements are suitable to detect sub clinical neurological damage among lead poisoning patients.