POEMS综合征神经传导异常分析

目的 阐明POEMS综合征的电生理特点.方法 对比分析22例POEMS综合征与22例慢性炎症性脱鞘性多发性神经根神经病(CIDP)患者的电生理资料.结果 POEMS组运动神经传导速度(MNCV)较CIDP组减低,但差异无统计学意义(P＞0.05);远端运动潜伏期(DML)明显减低,远端潜伏期指数(TLI)明显增高,差异均有统计学意义(P均＜0.05);POEMS组神经传导阻滞出现率较CIDP组低,差异有统计学意义(P＜0.05);POEMS组胫神经复合肌肉动作电位(CMAP)较CIDP组减低,差异有统计学意义(P＜0.05),而正中神经两组差异无统计学意义(P＞0.05);POEMS组下肢肌异常肌电出现率较上肢高,差异有统计学意义(P＜0.05).结论 POEMS综合征神经传导速度减慢主要在周围神经中间部分,传导阻滞出现率低,神经传导异常可能与上下肢体有关.

Analysis of nerve conduction abnormalities in POEMS syndrome

Objective To elucidate the electrophysiological features of POEMS syndrome. Methods We retrospectively analyzed the electrophysiological findings of 22 patients of POEMS, and compared their results with those of 22 patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Results Compared with the CIDP group, the motor nerve conduction velocity was decreased in the POEMS group, but the difference was not significantstatistically (P>0.05); whereas, distal motor latency (DML) was significantly decreased (P<0.05), and terminal latency index (TLI) was significantly increased (P<0.05). The incidence rate of the nerve conduction block in the POEMS group was lower than that in the CIDP group (P<0.05). Compound muscle action potential (CMAP) of the tibial nerve was decreased significantly in the POEMS group as compared with the CIDP group (P<0.05), whereas CMAP of the median nerve was not significantly different (P>0.05). Abnormal electrophysiology was frequently observed in muscles of lower limbs in the POEMS group, and in comparison of upper limbs, the difference was not significant statistically (P<0.05).Conclusion In POEMS syndrome, slowing of nerve conduction velocity is more predominant in the intermediate segments of the peripheral nerve, and conduction block is rare. Abnormal nerve conduction may be correlated with limbs.